Provider Demographics
NPI:1659253763
Name:CORNELIUS, CHRISTINE (MS RDN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CORNELIUS
Suffix:
Gender:F
Credentials:MS RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 W WITHERSPOON DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:CO
Mailing Address - Zip Code:80107-8850
Mailing Address - Country:US
Mailing Address - Phone:303-921-5157
Mailing Address - Fax:
Practice Address - Street 1:862 W WITHERSPOON DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107-8850
Practice Address - Country:US
Practice Address - Phone:303-921-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86023259133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered