Andrea Paul, R.D.N., L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI1163 Issued in ME

Practice address

33 Tucker Ave
Portland, ME 04103-1422

Phone

(207) 468-3074

NPI assigned

Jun 3, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1629636725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 TUCKER AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031422",
            "telephone_number": "207-468-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 TUCKER AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031422",
            "telephone_number": "207-468-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "ANDREA",
        "credential": "R.D.N., L.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI1163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Patterson, DO
• Sean Elizabeth Patterson, DO
• Margery Boody Pattison, LCSW
• Sarah Black Wiesendanger Patton, PA-C
• Paul Gerrard
• Katelynn Ruth Paul, LCSW
• Jennifer Paulus, LMSW-CC
• Elizabeth Ann Pavao, FNP, RNFA
• Douglas Michael Pavlak, MD
• Teresa Pawletkoo

• Registered Dietitian in Portland, ME
• Providers in Portland, ME by specialty
• Registered Dietitian in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.