NPI 1750696449 · live from the CMS NPI Registry
Kelly Marie Bristow, MS, RD, LD
Dietitian, Registered in Creve Coeur, MO. National Provider Identifier 1750696449, active.
NPI record
| NPI | 1750696449 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1020 N Mason Rd, Creve Coeur, MO 63141 |
| Practice phone | 314-996-3140 |
| Mailing address | 1020 N Mason Rd Ste 200, Hcia Cardiac Rehab, Creve Coeur, MO 63141 |
| Enumerated | August 18, 2010 |
| Last updated | November 1, 2017 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 2010026992 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.