Kimberly Ambrose, RDN
Individual provider Active NPI Registered Dietitian · Marietta, OH
NPI 1255211348 · NPPES record last updated Sep 8, 2025
Key facts
- NPI
- 1255211348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 6983 (OH)
- Practice address
- 216 Deerwalk Cir
Marietta, OH 45750-5378 - Phone
- (304) 593-1112
- NPI assigned
- Sep 8, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6983 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | 6983 | OH | Yes |
Addresses
Primary practice location
216 Deerwalk Cir
Marietta, OH 45750-5378
Mailing address
216 Deerwalk Cir
Marietta, OH 45750-5378
Other providers in Marietta, OH
- Corey Alley
- Als Hannas House Inc
- Maxwell Alsbach
- Hussein Alsharif
- Shannon Altazan
- America'S Home Health Care, LLC.
- American Home Health Care, Inc.
- Richard Ames
- Megan McKinzie Amos
- Anderson Medical Group
All providers in Marietta, OH · Registered Dietitian in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.