Provider Demographics
NPI:1538550504
Name:BROCHET, CHRISTINA JANE (MA, RD, LDN, CDCES)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JANE
Last Name:BROCHET
Suffix:
Gender:F
Credentials:MA, RD, LDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 STERNER MILL RD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-7702
Mailing Address - Country:US
Mailing Address - Phone:610-466-5649
Mailing Address - Fax:
Practice Address - Street 1:1284 STERNER MILL RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-7702
Practice Address - Country:US
Practice Address - Phone:610-466-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003456133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered