Provider Demographics
NPI:1215125810
Name:VINSON, SANDRA (RD)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:VINSON
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 1:806 SAINT VINCENTS DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1684
Mailing Address - Country:US
Mailing Address - Phone:205-930-1800
Mailing Address - Fax:205-930-1818
Practice Address - Street 1:806 SAINT VINCENTS DR
Practice Address - Street 2:SUITE 500
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1684
Practice Address - Country:US
Practice Address - Phone:205-930-1800
Practice Address - Fax:205-930-1818
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL434596133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education