Provider Demographics
NPI:1639449952
Name:JABLONSKI, KRISTIN (RD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:JABLONSKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 MAKAHIKI WAY
Mailing Address - Street 2:UNIT 303
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2862
Mailing Address - Country:US
Mailing Address - Phone:414-313-3703
Mailing Address - Fax:
Practice Address - Street 1:277 OHUA AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-6612
Practice Address - Country:US
Practice Address - Phone:808-922-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI986600133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered