Kelly Renea Bailey, RD, LD

Individual provider Active NPI Registered Dietitian · Mount Vernon, OH

NPI 1902085459 · NPPES record last updated Nov 1, 2007

Key facts

NPI
1902085459
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
6036 (OH)
Practice address
1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone
(740) 393-9147
NPI assigned
Nov 1, 2007
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

LicenseStateTypeSpecialty
6036OHMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 6036 OH Yes

Addresses

Primary practice location

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

Mailing address

1105 E Vine St
Mount Vernon, OH 43050-3658
Phone (740) 507-4858

Other names

  • Kelly Renea Connell Former name

Other providers in Mount Vernon, OH

All providers in Mount Vernon, OH · Registered Dietitian in Ohio

Sources for this page

Verify at the official NPI Registry.