Provider Demographics
NPI:1881049138
Name:ANDREWS, KATLYNN LORRA (MSHS, RD, LD)
Entity type:Individual
Prefix:
First Name:KATLYNN
Middle Name:LORRA
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MSHS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 DEER ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-3210
Mailing Address - Country:US
Mailing Address - Phone:219-680-9309
Mailing Address - Fax:
Practice Address - Street 1:1357 PINE CT
Practice Address - Street 2:APT 4
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1073
Practice Address - Country:US
Practice Address - Phone:219-680-9309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-24
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLRD.2047133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered