Provider Demographics
NPI:1508407198
Name:CHRISTY MALONEY NUTRITION LLC
Entity Type:Organization
Organization Name:CHRISTY MALONEY NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:GREENE
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:980-701-4194
Mailing Address - Street 1:5970 FAIRVIEW RD STE 420
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3167
Mailing Address - Country:US
Mailing Address - Phone:980-701-4191
Mailing Address - Fax:980-701-4194
Practice Address - Street 1:5970 FAIRVIEW RD STE 420
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3167
Practice Address - Country:US
Practice Address - Phone:980-701-4191
Practice Address - Fax:980-701-4194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty