Provider Demographics
NPI:1912322124
Name:LUEHMANN, CRISTEN L (MS, RLD)
Entity type:Individual
Prefix:MRS
First Name:CRISTEN
Middle Name:L
Last Name:LUEHMANN
Suffix:
Gender:F
Credentials:MS, RLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 WOOD STATION PL
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-6946
Mailing Address - Country:US
Mailing Address - Phone:314-616-0800
Mailing Address - Fax:
Practice Address - Street 1:12015 MANCHESTER RD STE 182
Practice Address - Street 2:
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-4417
Practice Address - Country:US
Practice Address - Phone:314-616-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001024956133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered