Provider Demographics
NPI:1225471600
Name:VALLANO, CHRISTINA L (RD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:VALLANO
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 1:118 NATURE PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6960
Mailing Address - Country:US
Mailing Address - Phone:724-532-2801
Mailing Address - Fax:724-532-2757
Practice Address - Street 1:118 NATURE PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6960
Practice Address - Country:US
Practice Address - Phone:724-532-2801
Practice Address - Fax:724-532-2757
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001167133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
14101253OtherCAQH
PA103364403Medicaid