Provider Demographics
NPI:1386768307
Name:ST. CLAIR, KRISTIN ANNE (RD)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ANNE
Last Name:ST. CLAIR
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 1:49 STARK HWY S
Mailing Address - Street 2:
Mailing Address - City:DUNBARTON
Mailing Address - State:NH
Mailing Address - Zip Code:03046-4407
Mailing Address - Country:US
Mailing Address - Phone:603-774-3594
Mailing Address - Fax:
Practice Address - Street 1:8 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3925
Practice Address - Country:US
Practice Address - Phone:603-577-2932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH725325133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered