Individual
KELSEY BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1916 N 700 W STE 250, LAYTON, UT 84041-5723
(801) 479-0312
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3500
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
115284934901
UT
133V00000X
Registered Dietitian
86049941
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154829109
—
UT
Enumeration date
01/24/2018
Last updated
03/30/2021
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