Provider Demographics
NPI:1043414295
Name:DUREN, KRISTEEN MICHELLE (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEEN
Middle Name:MICHELLE
Last Name:DUREN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 GREEN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-4928
Mailing Address - Country:US
Mailing Address - Phone:931-722-2820
Mailing Address - Fax:
Practice Address - Street 1:215 DEXTER L WOODS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-2416
Practice Address - Country:US
Practice Address - Phone:931-722-5466
Practice Address - Fax:931-722-9495
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN997133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3241398Medicare ID - Type Unspecified