Provider Demographics
NPI:1649820697
Name:SCHULTE, CHRISTINE (RD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:CONNAUGHTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1478 EAST HIGHWAY 162
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA CREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84534-0130
Mailing Address - Country:US
Mailing Address - Phone:435-651-3700
Mailing Address - Fax:
Practice Address - Street 1:1478 EAST HIGHWAY 162
Practice Address - Street 2:
Practice Address - City:MONTEZUMA CREEK
Practice Address - State:UT
Practice Address - Zip Code:84534-8453
Practice Address - Country:US
Practice Address - Phone:435-651-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11780637-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered