Provider Demographics
NPI:1871167650
Name:CHRISTIAN, MADISON HOPE (MS, RDN, LDN)
Entity type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:HOPE
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 HIGHWAY 280 WEST BUILDING 1B
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31719
Mailing Address - Country:US
Mailing Address - Phone:229-931-1226
Mailing Address - Fax:229-931-7162
Practice Address - Street 1:126 HIGHWAY 280 WEST BUILDING 1B
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31719
Practice Address - Country:US
Practice Address - Phone:229-931-1226
Practice Address - Fax:229-931-7162
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86116595133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered