Provider Demographics
NPI:1861852329
Name:WAITE, CHRISTINE (MBA, RDN)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:WAITE
Suffix:
Gender:F
Credentials:MBA, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7641 S TOWEL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-2227
Mailing Address - Country:US
Mailing Address - Phone:480-331-9093
Mailing Address - Fax:
Practice Address - Street 1:7641 S TOWEL CREEK DR
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-2227
Practice Address - Country:US
Practice Address - Phone:480-331-9093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1057422133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered