Provider Demographics
NPI:1730745050
Name:SUNDERMAN, CHRISTINA A (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:A
Last Name:SUNDERMAN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3229 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3018
Mailing Address - Country:US
Mailing Address - Phone:513-872-6397
Mailing Address - Fax:
Practice Address - Street 1:3229 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3018
Practice Address - Country:US
Practice Address - Phone:513-872-6397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5459133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered