Individual
KELLY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
3455 LUTHERAN PKWY, WHEAT RIDGE, CO 80033-6028
(303) 403-3039
Mailing address
3041 CASTLE PEAK AVE, SUPERIOR, CO 80027-6071
(317) 220-9809
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86021227
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86021227
RD LICENSURE
—
Enumeration date
01/18/2022
Last updated
01/18/2022
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