Healthcare Provider Details

I. General information

NPI: 1295503522
Provider Name (Legal Business Name): KRISTINA EL-KHOURI MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE
GREENSBORO NC
27401-1230
US

IV. Provider business mailing address

1607 SPRING GARDEN ST STE A
GREENSBORO NC
27403-2345
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-3236
  • Fax:
Mailing address:
  • Phone: 770-722-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL007392
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: