Provider Demographics
NPI:1861437485
Name:MCKINNEY, CHRISTINE DAWN (RD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:DAWN
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:DAWN
Other - Last Name:MATTSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1006 ROLAND HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1237
Mailing Address - Country:US
Mailing Address - Phone:410-889-0450
Mailing Address - Fax:410-550-0650
Practice Address - Street 1:4940 EASTERN AVENUE
Practice Address - Street 2:JOHNS HOPKINS BAYVIEW MEDICAL CENTER CLINICAL NUTRITION
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2780
Practice Address - Country:US
Practice Address - Phone:410-550-1549
Practice Address - Fax:410-550-0650
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDO2307133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered