Provider Demographics
NPI:1831255637
Name:WALAHOSKI, KRISTINE MARIE (RD, LMNT)
Entity type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:MARIE
Last Name:WALAHOSKI
Suffix:
Gender:F
Credentials:RD, LMNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 J STREET
Mailing Address - Street 2:
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862
Mailing Address - Country:US
Mailing Address - Phone:308-728-9965
Mailing Address - Fax:
Practice Address - Street 1:10 E 31ST ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2926
Practice Address - Country:US
Practice Address - Phone:308-865-2640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE669133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered