Provider Demographics
NPI:1427703347
Name:SANFORD, WHITNEY (RDN)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:SANFORD
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1513
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83816-1513
Mailing Address - Country:US
Mailing Address - Phone:208-699-0605
Mailing Address - Fax:208-601-6123
Practice Address - Street 1:924 N 17TH ST
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5551
Practice Address - Country:US
Practice Address - Phone:208-699-0605
Practice Address - Fax:208-601-6123
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered