Provider Demographics
NPI:1124893102
Name:ANDREWS, JULIE KAY (MS, RDN, FAND)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:KAY
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MS, RDN, FAND
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KAY
Other - Last Name:ROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:6210 WOODMARK AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9443
Mailing Address - Country:US
Mailing Address - Phone:616-723-4731
Mailing Address - Fax:
Practice Address - Street 1:6210 WOODMARK AVE NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-9443
Practice Address - Country:US
Practice Address - Phone:616-723-4731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI01022742133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty