Provider Demographics
NPI:1932636479
Name:LINDSEY, KRISTINA (MPH, RDN, LD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:MPH, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04021-3723
Mailing Address - Country:US
Mailing Address - Phone:207-838-8668
Mailing Address - Fax:
Practice Address - Street 1:60 FOREST FALLS DR
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6971
Practice Address - Country:US
Practice Address - Phone:207-560-3915
Practice Address - Fax:207-560-3922
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI711133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered