MEDICARE: KRISTINA ERIN GREENBERG RD, CSR

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133V00000X	Registered Dietitian
2	133N00000X	Nutritionist
3	133NN1002X	Nutrition Education Nutritionist
4	133VN1005X	Renal Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1164065629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA ERIN GREENBERG RD, CSR

Provider Business Mailing Address
First Line	:	75 CIRCLE POINTE DR
Second Line	:
City	:	ZION CROSSROADS
State	:	VA
Zip	:	22942-6935
Country	:	US
Telephone Number	:	434-924-9009
Fax Number	:	434-924-9256

Provider Business Practice Location Address
First Line	:	75 CIRCLE POINTE DR
Second Line	:
City	:	ZION CROSSROADS
State	:	VA
Zip	:	22942-6935
Country	:	US
Telephone Number	:	434-924-9009
Fax Number	:	434-924-9256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2019
Last Update Date	:	10/28/2019

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