Provider Demographics
NPI:1033627625
Name:BAIG, KHRYSTA ANN MARIE (MSPH, RD, LDN, CHES)
Entity Type:Individual
Prefix:
First Name:KHRYSTA
Middle Name:ANN MARIE
Last Name:BAIG
Suffix:
Gender:F
Credentials:MSPH, RD, LDN, CHES
Other - Prefix:
Other - First Name:KHRYSTA
Other - Middle Name:ANN MARIE
Other - Last Name:DUNKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2150 WILSON RD APT C10
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-6070
Mailing Address - Country:US
Mailing Address - Phone:618-201-5730
Mailing Address - Fax:
Practice Address - Street 1:400 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37902-2405
Practice Address - Country:US
Practice Address - Phone:865-215-3153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000002761133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered