Healthcare Provider Details

I. General information

NPI: 1780453365
Provider Name (Legal Business Name): KRISTINA RACHELLE SINGH RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTINA RACHELLE BAIRD

II. Dates (important events)

Enumeration Date: 12/25/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MAIN ST FL 18
COLUMBIA SC
29201-2435
US

IV. Provider business mailing address

1901 MAIN ST FL 18
COLUMBIA SC
29201-2435
US

V. Phone/Fax

Practice location:
  • Phone: 912-678-9549
  • Fax: 800-878-1975
Mailing address:
  • Phone: 912-678-9549
  • Fax: 800-878-1975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberL007629
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLRD.2988
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number164.011692
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD006822
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: