Provider Demographics
NPI:1639331481
Name:LINDSEY-DUDLEY, KRISTEN JOAN (RD MPH)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:JOAN
Last Name:LINDSEY-DUDLEY
Suffix:
Gender:F
Credentials:RD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 WAIALAE AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2650
Mailing Address - Country:US
Mailing Address - Phone:808-737-3993
Mailing Address - Fax:808-738-5566
Practice Address - Street 1:3465 WAIALAE AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2650
Practice Address - Country:US
Practice Address - Phone:808-737-3993
Practice Address - Fax:808-738-5566
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI647811133V00000X
HI145-D133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered