Provider Demographics
NPI:1659123834
Name:HOLLEMAN, CHRISTINA (RD, LD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:HOLLEMAN
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FAIRVIEW LN
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-8204
Mailing Address - Country:US
Mailing Address - Phone:617-233-0240
Mailing Address - Fax:
Practice Address - Street 1:4 FAIRVIEW LN
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-8204
Practice Address - Country:US
Practice Address - Phone:617-233-0240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1861133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered