Individual
KRISTINA LEA PENNISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., PH.D
Contact information
Practice address
600 HIGHLAND AVE, F4/320 CLINICAL SCIENCE CENTER, MADISON, WI 53792-3236
(608) 265-9797
(608) 262-6453
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1444-029
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1444-029
RD, PHD
WI
Enumeration date
12/18/2009
Last updated
10/27/2021
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