Individual
KELLY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1 SPARKS AVE, JAMESTOWN, KY 42629-2449
(270) 343-2101
Mailing address
2370 CAVE MILL STATION BLVD APT 922, BOWLING GREEN, KY 42104-6407
(615) 815-5810
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
252072
KY
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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