Individual
MARY ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
705 MAIN ST, SIMPSON, PA 18407-1215
(570) 955-7133
Mailing address
705 MAIN ST, SIMPSON, PA 18407-1215
(570) 955-7133
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
816228
NY
133V00000X
Registered Dietitian
Primary
DN000257
PA
133V00000X
Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346340445
NUTRITION
NY
05
—
1346340445
—
NY
Enumeration date
09/25/2006
Last updated
10/27/2025
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