Individual
KIMBERLY M CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSH, RD, LD/N
Contact information
Practice address
632 MAJESTIC EAGLE DR, PONTE VEDRA, FL 32081-0611
(904) 553-1179
Mailing address
632 MAJESTIC EAGLE DR, PONTE VEDRA, FL 32081-0611
(904) 553-1179
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
ND4882
FL
133V00000X
Registered Dietitian
Primary
963168
FL
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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