Andrea Katherine Carpenter, MS, RD, CSP, LD, CBS

Individual provider Active NPI Pediatric Nutrition Registered Dietitian · Signal Mountain, TN

NPI 1396562344 · NPPES record last updated Oct 22, 2024

Key facts

NPI
1396562344
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nutrition Registered Dietitian 133VN1004X
License
4415 (TN)
Practice address
396 Timberlinks Dr
Signal Mountain, TN 37377-1945
Phone
(334) 740-4500
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
The Nicu Dietitian LLC Nutrition, Pediatric Current
since Oct 20, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 4415 TN
Pediatric Critical Care Nutrition Registered Dietitian 133VN1401X 4415 TN
Pediatric Nutrition Registered Dietitian 133VN1004X 4415 TN Yes

Addresses

Primary practice location

396 Timberlinks Dr
Signal Mountain, TN 37377-1945

Mailing address

396 Timberlinks Dr
Signal Mountain, TN 37377-1945
Phone (334) 740-4500

Other providers in Signal Mountain, TN

All providers in Signal Mountain, TN · Pediatric Nutrition Registered Dietitian in Tennessee

Sources for this page

Verify at the official NPI Registry.