Individual
ANDI M COFFEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NUTRITIONIST
Contact information
Practice address
1928 W ST EXUPERY DR, ANTHEM, AZ 85086-3623
(602) 478-3709
Mailing address
3613 W SOUSA CT, ANTHEM, AZ 85086-6022
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
18329
AZ
133N00000X
Nutritionist
DX5894
MD
133N00000X
Nutritionist
ND11884
FL
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
171400000X
Health & Wellness Coach
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167494
NUTRITIONIST
—
Enumeration date
08/11/2020
Last updated
12/30/2024
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