NPI 1013255066 · live from the CMS NPI Registry
Andrea Addley
Dietitian, Registered in Salt Lake City, UT. National Provider Identifier 1013255066, active.
NPI record
| NPI | 1013255066 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1174 E Graystone Way Ste 1a, Salt Lake City, UT 84106 |
| Practice phone | 801-664-2182 |
| Mailing address | 715 Ranch Loop Rd, Preston, ID 83263 |
| Enumerated | January 26, 2013 |
| Last updated | February 5, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 6511772-4901 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.