Provider Demographics
NPI:1720660889
Name:NEGRETE, CHRISTINA (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:NEGRETE
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1974 TRAVER RD APT 105
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1268
Mailing Address - Country:US
Mailing Address - Phone:206-822-5365
Mailing Address - Fax:
Practice Address - Street 1:441 S LIVERNOIS RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2585
Practice Address - Country:US
Practice Address - Phone:248-608-8800
Practice Address - Fax:248-608-2490
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86289330133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered