Provider Demographics
NPI:1285975953
Name:KENDRICK, ANDREA WOLFER (RD, LDN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:WOLFER
Last Name:KENDRICK
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 N FOREST PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5136
Mailing Address - Country:US
Mailing Address - Phone:865-344-0949
Mailing Address - Fax:865-221-8087
Practice Address - Street 1:407 N FOREST PARK BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5136
Practice Address - Country:US
Practice Address - Phone:865-344-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000002331133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered