Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 1258 | AL |
N | 111NN1001X | Nutrition | 5142 | TX |
N | 111NN1001X | Nutrition | 857 | LA |
Y | 111NN1001X | Nutrition | CH5940 | FL |
NPI | 1063699320 |
---|---|
Provider Name | Dr. Teresa Kristine Cardwell |
First Address | Sunny Isles Beach, FL 33160-4533 |
Second Address | Sunny Isles Beach, FL 33160-4533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2008 |
Last Update Date | 29/01/2008 |