Provider Demographics
NPI:1245946458
Name:MYERS, KRISTEN (RDN)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:ABRAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10331 MUSTANG RDG
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2478
Mailing Address - Country:US
Mailing Address - Phone:813-619-9291
Mailing Address - Fax:
Practice Address - Street 1:10331 MUSTANG RDG
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2478
Practice Address - Country:US
Practice Address - Phone:813-619-9291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88284133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered