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NPI Code Detail

MEDICARE: CHRISTINA KAYE SENFF MPA, RD, CD, CDE

MEDICARE: CHRISTINA KAYE SENFF MPA, RD, CD, CDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian37000601AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1447127OTHERADA/CDR REGISTRATION

General Provider Information

NPI Number : 1760560114
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA KAYE SENFF MPA, RD, CD, CDE
Provider Business Mailing Address
First Line : 215 W 16TH ST
Second Line :
City : MISHAWAKA
State : IN
Zip : 46544-5206
Country : US
Telephone Number : 574-258-1040
Fax Number :
Provider Business Practice Location Address
First Line : 215 W 4TH ST
Second Line :
City : MISHAWAKA
State : IN
Zip : 46544-1917
Country : US
Telephone Number : 574-258-1366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 07/09/2007

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