Provider Demographics
NPI:1124417019
Name:LEWIS, CHRISTINA (RD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 303
Mailing Address - Street 2:BOX 61
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96204-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 303
Practice Address - Street 2:BOX 61
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96204-9998
Practice Address - Country:US
Practice Address - Phone:0102-516-7242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5747133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered