Provider Demographics
NPI:1164809653
Name:LUND, CHRISTINA JO (RDN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:JO
Last Name:LUND
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 LEADVILLE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2974
Mailing Address - Country:US
Mailing Address - Phone:702-521-5458
Mailing Address - Fax:
Practice Address - Street 1:900 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6425
Practice Address - Country:US
Practice Address - Phone:702-369-3699
Practice Address - Fax:702-369-3644
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV892945133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered