Provider Demographics
NPI:1619378130
Name:ROBINSON, KRISTEN (RD, LD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4637 CHIPPEWA WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7339
Mailing Address - Country:US
Mailing Address - Phone:314-809-7285
Mailing Address - Fax:
Practice Address - Street 1:12765 PARKWAY ESTATES DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3769
Practice Address - Country:US
Practice Address - Phone:314-809-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013030050133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered