Provider Demographics
NPI:1942386255
Name:NEJDL, CHRISTINE DIANE (RD,LD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:DIANE
Last Name:NEJDL
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 E WALLINGS RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-1387
Mailing Address - Country:US
Mailing Address - Phone:440-227-7480
Mailing Address - Fax:
Practice Address - Street 1:1000 W WALLINGS RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-1200
Practice Address - Country:US
Practice Address - Phone:440-227-7480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4640133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered