Provider Demographics
NPI:1760560114
Name:SENFF, CHRISTINA KAYE (MPA, RD, CD, CDE)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:KAYE
Last Name:SENFF
Suffix:
Gender:F
Credentials:MPA, RD, CD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-5206
Mailing Address - Country:US
Mailing Address - Phone:574-258-1040
Mailing Address - Fax:
Practice Address - Street 1:215 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-1917
Practice Address - Country:US
Practice Address - Phone:574-258-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37000601A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
447127OtherADA/CDR REGISTRATION
IN9407808AMedicare PIN