Individual
KELLIE A WESTERCAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
515 N MAIN ST, CARROLL, IA 51401-2739
(712) 792-4000
(712) 792-3554
Mailing address
515 N MAIN ST, CARROLL, IA 51401-2739
(712) 792-4000
(712) 792-3554
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01704
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71934
MEDICARE GROUP NUMBER
IA
Enumeration date
05/04/2006
Last updated
11/29/2007
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