Provider Demographics
NPI:1669919932
Name:MINGES, CHRISTINA (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MINGES
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:OKEANA
Mailing Address - State:OH
Mailing Address - Zip Code:45053-9505
Mailing Address - Country:US
Mailing Address - Phone:419-769-0619
Mailing Address - Fax:
Practice Address - Street 1:3724 JEFFERSON ST STE 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6204
Practice Address - Country:US
Practice Address - Phone:512-693-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN37002209A133V00000X
KY290560133V00000X
TXDT90070133V00000X
OHLD.6971133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered