Provider Demographics
NPI:1154613891
Name:CHRISTINA, JENNA (RD)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:CHRISTINA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 N GEORGE MASON DR
Mailing Address - Street 2:SUITE 334
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3683
Mailing Address - Country:US
Mailing Address - Phone:703-717-4253
Mailing Address - Fax:703-717-4251
Practice Address - Street 1:1625 N GEORGE MASON DR
Practice Address - Street 2:SUITE 334
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3683
Practice Address - Country:US
Practice Address - Phone:703-717-4253
Practice Address - Fax:703-717-4251
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered