Provider Demographics
NPI:1700633690
Name:LOMBARDO, KRISTY ROBINSON (CNS, LDN, NBC-HWC)
Entity type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:ROBINSON
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:CNS, LDN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7203 N PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3037
Mailing Address - Country:US
Mailing Address - Phone:317-258-0609
Mailing Address - Fax:
Practice Address - Street 1:7203 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3037
Practice Address - Country:US
Practice Address - Phone:317-258-0609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX6469133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist