Provider Demographics
NPI:1356998199
Name:FERROLI, CHRISTINA ELIZABETH (PHD, RDN, LDN, FAND)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:FERROLI
Suffix:
Gender:F
Credentials:PHD, RDN, LDN, FAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12583 BROMPTON RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3186
Mailing Address - Country:US
Mailing Address - Phone:317-208-0574
Mailing Address - Fax:
Practice Address - Street 1:12583 BROMPTON RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-3186
Practice Address - Country:US
Practice Address - Phone:317-208-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37003043A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered