Provider Demographics
NPI:1609241744
Name:BEITLER, CHRISTINA M (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:BEITLER
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 FREEMANSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5535
Mailing Address - Country:US
Mailing Address - Phone:610-691-6522
Mailing Address - Fax:610-691-3040
Practice Address - Street 1:5250 FREEMANSBURG AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5535
Practice Address - Country:US
Practice Address - Phone:610-691-6522
Practice Address - Fax:610-691-3040
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005154133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered