Provider Demographics
NPI:1811334808
Name:KITTRIDGE, KRISTINE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:KITTRIDGE
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 N MAIN ST
Mailing Address - Street 2:DIABETES AND NUTRITION CLINIC
Mailing Address - City:PITTSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04967-3707
Mailing Address - Country:US
Mailing Address - Phone:207-487-4068
Mailing Address - Fax:
Practice Address - Street 1:447 N MAIN ST
Practice Address - Street 2:DIABETES AND NUTRITION CLINIC
Practice Address - City:PITTSFIELD
Practice Address - State:ME
Practice Address - Zip Code:04967-3707
Practice Address - Country:US
Practice Address - Phone:207-487-4068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
METD1143133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered