Provider Demographics
NPI:1780453365
Name:SINGH, KRISTINA RACHELLE (RD, LD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:RACHELLE
Last Name:SINGH
Suffix:
Gender:
Credentials:RD, LD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:RACHELLE
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6650 RIVERS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4809
Mailing Address - Country:US
Mailing Address - Phone:803-216-1368
Mailing Address - Fax:
Practice Address - Street 1:6650 RIVERS AVE STE 100
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4809
Practice Address - Country:US
Practice Address - Phone:803-216-1368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLRD.2988133V00000X
NCL007629133V00000X
IL164.011692133V00000X
GALD006822133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered