Individual
MS. KRISTEN ERNST PETTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
226 WALNUT ST, MONTCLAIR, NJ 07042-2972
(973) 224-7644
(973) 695-2003
Mailing address
PO BOX 43463, UPPER MONTCLAIR, NJ 07043-0463
(973) 224-7644
(973) 695-2003
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
631196
—
133VN1005X
Renal Nutrition Registered Dietitian
Primary
631196
—
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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