Provider Demographics
NPI:1770958688
Name:SEIXAS, KRISTINA (RD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SEIXAS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:LOPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:450 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:STE 8C
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-5300
Mailing Address - Country:US
Mailing Address - Phone:401-396-9331
Mailing Address - Fax:401-396-9369
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY
Practice Address - Street 2:STE 8C
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-396-9331
Practice Address - Fax:401-396-9369
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00818133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered