Individual
KRISTINA PESTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNS, LDN
Contact information
Practice address
412 ELDEN ST, HERNDON, VA 20170-4511
(703) 657-0303
Mailing address
1126 N TAYLOR ST, ARLINGTON, VA 22201-4789
(786) 205-4044
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DX4628
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DX4628
STATE BOARD OF DIETETIC PRACTICE
MD
Enumeration date
02/06/2019
Last updated
09/22/2022
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