Provider Demographics
NPI:1386892644
Name:OSTERMEIER, SANDRA K (RD LD CN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:OSTERMEIER
Suffix:
Gender:F
Credentials:RD LD CN
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:K
Other - Last Name:O'SHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 GLENNS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-2473
Mailing Address - Country:US
Mailing Address - Phone:502-564-2585
Mailing Address - Fax:502-564-9640
Practice Address - Street 1:100 GLENNS CREEK RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-2473
Practice Address - Country:US
Practice Address - Phone:502-564-2585
Practice Address - Fax:502-564-9640
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2056133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist