Individual
KELSEY DANAE FENTRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1192 TEN MILE RD, BONIFAY, FL 32425-6208
(270) 348-0442
Mailing address
1192 TEN MILE RD, BONIFAY, FL 32425-6208
(270) 348-0442
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
174366
AK
133V00000X
Registered Dietitian
2306
KY
133V00000X
Registered Dietitian
Primary
5276
AL
133V00000X
Registered Dietitian
ND12329
FL
Other
Enumeration date
11/29/2010
Last updated
03/05/2025
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