Individual
KELLY HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
12200 CORDOVA AVE NE, ALBUQUERQUE, NM 87112-2520
(505) 332-8070
Mailing address
12200 CORDOVA AVE NE, ALBUQUERQUE, NM 87112-2520
(505) 332-8070
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-0883
NM
Other
Enumeration date
09/28/2014
Last updated
09/28/2014
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