NPI 1396578985 · live from the CMS NPI Registry
Kelly Ana Douglass, RD
Dietitian, Registered in Las Vegas, NV. National Provider Identifier 1396578985, active.
NPI record
| NPI | 1396578985 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 8480 S Eastern Ave Ste F, Las Vegas, NV 89123 |
| Practice phone | 833-759-8720 |
| Mailing address | Po Box 777447, Henderson, NV 89077 |
| Enumerated | August 21, 2024 |
| Last updated | July 20, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | — (AZ) |
| Dietitian, Registered | 133V00000X | — (CA) |
| Dietitian, Registered | 133V00000X | — (MI) |
| Dietitian, Registered | 133V00000X | — (VA) |
| Dietitian, Registered | 133V00000X | — (CO) |
| Dietitian, Registered | 133V00000X | 1733 (ND) |
| Dietitian, Registered primary | 133V00000X | 40902-DI-0 (NV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.