Most Relevant Information
Provider Data
| NPI Number: | 1003566944 |
| Provider Name: | DEANNA RUTH ANDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | ND9720 |
Most Important Dates
| Enumeration Date: | 03/24/2022 |
| Last Updated: | 03/24/2022 |
Provider Practice Location
1000 MAR WALT DR
FORT WALTON BEACH
FL
325476708
Practice Location Phone/Fax
| Phone: | 8508621111 |
| Fax: |
Provider Mailing Location
1016 VALPARAISO BLVD
NICEVILLE
FL
325783500
Provider Mailing Phone/Fax
| Phone: | 2252768226 |
| Fax: |