Individual
KELSI EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
932 N RUTLEDGE ST, SPRINGFIELD, IL 62702-3721
(217) 788-3948
Mailing address
932 N RUTLEDGE ST, SPRINGFIELD, IL 62702-3721
(217) 788-3948
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164005728
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1076575
CDR
IL
Enumeration date
12/05/2016
Last updated
12/05/2016
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