Provider Demographics
NPI:1770826380
Name:SESSUMS, KRISTIN (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:SESSUMS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:MRS
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:SESSUMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,RD,LC
Mailing Address - Street 1:3322 W END AVE
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1031
Mailing Address - Country:US
Mailing Address - Phone:615-515-9880
Mailing Address - Fax:615-515-9891
Practice Address - Street 1:1110 BROAD AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-8907
Practice Address - Country:US
Practice Address - Phone:228-243-0880
Practice Address - Fax:228-284-1635
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD1295133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered