Provider Demographics
NPI:1902679947
Name:CARMAN, KRISTINA MELANIE
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:MELANIE
Last Name:CARMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CORAL ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4410
Mailing Address - Country:US
Mailing Address - Phone:854-205-0032
Mailing Address - Fax:
Practice Address - Street 1:610 CORAL ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4410
Practice Address - Country:US
Practice Address - Phone:854-205-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist