Provider Demographics
NPI:1689548745
Name:VENARSKE, KRISTIN FAITH (MS, RD LDN)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:FAITH
Last Name:VENARSKE
Suffix:
Gender:F
Credentials:MS, RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 OLD MAYHEW RD APT 56
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-9254
Mailing Address - Country:US
Mailing Address - Phone:601-319-1249
Mailing Address - Fax:
Practice Address - Street 1:193 OLD MAYHEW RD APT 56
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-9254
Practice Address - Country:US
Practice Address - Phone:601-319-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2734133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered