Provider Demographics
NPI:1942042999
Name:KRISTEN NORIEGA NUTRITION, LLC
Entity type:Organization
Organization Name:KRISTEN NORIEGA NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTEK
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:660-528-0415
Mailing Address - Street 1:6404 90TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-6866
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2012 BURSON DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-5304
Practice Address - Country:US
Practice Address - Phone:660-528-0415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty