Provider Demographics
NPI:1518856194
Name:SASSE, CHRISTINE LYNN (RDN, LD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNN
Last Name:SASSE
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LIMOGES CT
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6765
Mailing Address - Country:US
Mailing Address - Phone:501-392-2911
Mailing Address - Fax:
Practice Address - Street 1:130 LIMOGES CT
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6765
Practice Address - Country:US
Practice Address - Phone:501-392-2911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR453133VN1201X, 133V00000X, 133VN1004X, 133NN1002X
174H00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No174H00000XOther Service ProvidersHealth Educator
No251K00000XAgenciesPublic Health or Welfare
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education