Provider Demographics
NPI:1225092836
Name:FOUT, KRISTINE E (RD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:E
Last Name:FOUT
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 1:450 WEST TENTH AVENUE
Mailing Address - Street 2:DEPARTMENT OF NUTRITION S-07 RHODES HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210
Mailing Address - Country:US
Mailing Address - Phone:614-293-2300
Mailing Address - Fax:614-293-3740
Practice Address - Street 1:450 WEST TENTH AVENUE
Practice Address - Street 2:DEPT OF NUTRITION 9-07 RHODES HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210
Practice Address - Country:US
Practice Address - Phone:614-293-2300
Practice Address - Fax:614-293-3740
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2050133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHFOMT02901Medicare PIN