Provider Demographics
NPI:1831355056
Name:BUCHANAN, SANDRA J (RD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ASHELAND AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4016
Mailing Address - Country:US
Mailing Address - Phone:828-258-8681
Mailing Address - Fax:828-253-4830
Practice Address - Street 1:206 ASHELAND AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4016
Practice Address - Country:US
Practice Address - Phone:828-258-8681
Practice Address - Fax:828-253-4830
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000942133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered