Provider Demographics
NPI:1437622198
Name:HESS, KRISTINA ISABEL (CNS)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:ISABEL
Last Name:HESS
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 OLD KINGS HWY S FL 1
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4551
Mailing Address - Country:US
Mailing Address - Phone:203-984-7989
Mailing Address - Fax:
Practice Address - Street 1:30 OLD KINGS HWY S FL 1
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4551
Practice Address - Country:US
Practice Address - Phone:203-984-7989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-05
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1714133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist