NPI 1356760391 · live from the CMS NPI Registry
Andrea K Ackerson, RD IBCLC
Dietitian, Registered in Providence, RI. National Provider Identifier 1356760391, active.
NPI record
| NPI | 1356760391 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 383 W Fountain St # 115, Providence, RI 02903 |
| Practice phone | 401-203-7248 |
| Mailing address | 171 Forge Rd, North Kingstown, RI 02852 |
| Enumerated | April 7, 2014 |
| Last updated | November 5, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Lactation Consultant, Non-RN | 174N00000X | L56279 (RI) |
| Dietitian, Registered primary | 133V00000X | 928270 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.