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Individual

MRS. KELLY JOY QUISENBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD LD

Contact information

Practice address
4320 DIPLOMACY DR STE 3181, SOUTHCENTRAL FOUNDATION, ANCHORAGE, AK 99508-5925
(907) 729-4371
(907) 729-4135
Mailing address
2431 TRADEWIND DR, ANCHORAGE, AK 99516-3402
(305) 978-5814

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
268
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1584514
AK
Enumeration date
06/07/2011
Last updated
03/27/2014
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