Provider Demographics
NPI:1538121587
Name:MORAN, CHRISTINE MARIE (RD, LD, MA)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:MORAN
Suffix:
Gender:F
Credentials:RD, LD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MORNING MIST LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-2834
Mailing Address - Country:US
Mailing Address - Phone:912-414-5922
Mailing Address - Fax:
Practice Address - Street 1:5 MORNING MIST LN
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31411-2834
Practice Address - Country:US
Practice Address - Phone:912-414-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003513133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
727867OtherREGISTERED DIETITIAN