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Individual

KRISTEN AVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LD, CDCES

Contact information

Practice address
181 ARMOUR DR NE, ATLANTA, GA 30324-3916
(404) 981-6533
Mailing address
1524 DEERWOOD DR, DECATUR, GA 30030-4516

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD005269
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22200347
CERTIFICATION BOARD FOR DIABETES CARE AND EDUCATION
01
86032146
COMMISSION ON DIETETIC REGISTRATION
01
LD005269
GEORGIA PROFESSIONAL LICENSING BOARD
GA
Enumeration date
10/12/2020
Last updated
10/12/2020
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