Individual
KELLY BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
711 HAMBRICK AVE, LEXINGTON, KY 40508-2307
(818) 641-4892
Mailing address
PO BOX 368, STANVILLE, KY 41659-0368
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
KY
Other
Enumeration date
03/19/2020
Last updated
01/27/2022
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