Provider Demographics
NPI:1912340142
Name:BARNES, ANDREA M (MS, RD, LDN, FAND)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:M
Last Name:BARNES
Suffix:
Gender:F
Credentials:MS, RD, LDN, FAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8695 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:GERMANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18053-2724
Mailing Address - Country:US
Mailing Address - Phone:484-866-1115
Mailing Address - Fax:
Practice Address - Street 1:187 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049
Practice Address - Country:US
Practice Address - Phone:610-421-4849
Practice Address - Fax:610-421-4303
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004171133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered