Provider Demographics
NPI:1154179083
Name:ANDERSON, LINDSAY ANNE (MA, RD)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:ANNE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4358 SHERWOOD FOREST CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9472
Mailing Address - Country:US
Mailing Address - Phone:734-417-7562
Mailing Address - Fax:
Practice Address - Street 1:4358 SHERWOOD FOREST CT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9472
Practice Address - Country:US
Practice Address - Phone:734-417-7562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13197133V00000X
MI133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered