Provider Demographics
NPI:1942749668
Name:PINK, KRISTI (MPH, RD, LDN)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:PINK
Suffix:
Gender:F
Credentials:MPH, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 LYNDALE AVE S
Mailing Address - Street 2:SUITE 500
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2373
Mailing Address - Country:US
Mailing Address - Phone:612-296-8660
Mailing Address - Fax:
Practice Address - Street 1:6625 LYNDALE AVE S
Practice Address - Street 2:SUITE 500
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2373
Practice Address - Country:US
Practice Address - Phone:612-296-8660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN194133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist