Alice M Kelley, RD
Individual provider Active NPI Registered Dietitian · Providence, KY
NPI 1578884052 · NPPES record last updated May 4, 2011
Key facts
- NPI
- 1578884052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 0164 (KY)
- Practice address
- 215 E Main St
Providence, KY 42450-1261 - Phone
- (270) 667-7017
- NPI assigned
- Jun 18, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0164 | KY | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 0164 | KY | Yes |
Addresses
Primary practice location
215 E Main St
Providence, KY 42450-1261
Mailing address
215 E Main St
Providence, KY 42450-1261
Phone (270) 667-7017
Other providers in Providence, KY
- Amy Michele Hart
- David L Higgins
- Sharon Hodges
- Kimberly Ann Jackson
- James D. Phillips, DMD,PSC
- Kayla Jean Kukahiko
- Winona F Lambdin
- Tristan K Lineberry
- Brad Long
- Joseph Lowery
All providers in Providence, KY · Registered Dietitian in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 4, 2011. 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.