Provider Demographics
NPI:1740744333
Name:JOHNSON, CHRISTYNA (RDN)
Entity type:Individual
Prefix:
First Name:CHRISTYNA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18800 LINA ST APT 1413
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-2506
Mailing Address - Country:US
Mailing Address - Phone:314-952-9725
Mailing Address - Fax:
Practice Address - Street 1:18800 LINA ST APT 1413
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-2506
Practice Address - Country:US
Practice Address - Phone:314-952-9725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered