Provider Demographics
NPI:1144957093
Name:KJELL, MICHELLE (RD/LD)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:KJELL
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PERKINS SQUARE AKRON CHILDRENS HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308
Mailing Address - Country:US
Mailing Address - Phone:330-543-8625
Mailing Address - Fax:
Practice Address - Street 1:1 PERKINS SQUARE AKRON CHILDRENS HOSPITAL
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308
Practice Address - Country:US
Practice Address - Phone:330-543-8625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD5761133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered