Provider Demographics
NPI:1649657446
Name:SWAIN, CHRISTINA LYNN BERRY (MS, RD, CSSD, LDN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNN BERRY
Last Name:SWAIN
Suffix:
Gender:F
Credentials:MS, RD, CSSD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 CHELSEA DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-8541
Mailing Address - Country:US
Mailing Address - Phone:813-400-5274
Mailing Address - Fax:
Practice Address - Street 1:688 CHELSEA DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-8541
Practice Address - Country:US
Practice Address - Phone:813-400-5274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL007335133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics