Provider Demographics
NPI:1477121051
Name:CULHANE, ALEXIS (RDN)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:CULHANE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:165 CAMBRIDGEPARK DR UNIT 542
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:185 WASHINGTON ST APT 301
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3550
Practice Address - Country:US
Practice Address - Phone:952-452-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.10800133V00000X
MN4628133V00000X
MALDN5330133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered