NPI 1255021135 · live from the CMS NPI Registry
Kelsey Marie Bruner, RD
Dietitian, Registered in Newburgh, IN. National Provider Identifier 1255021135, active.
NPI record
| NPI | 1255021135 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 4255 Medwell Drive, Newburgh, IN 47630 |
| Practice phone | 812-853-2993 |
| Mailing address | 22 Quail Crossing Dr, Boonville, IN 47601 |
| Enumerated | May 12, 2023 |
| Last updated | May 12, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 37003279A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.