Provider Demographics
NPI:1548788904
Name:REED, KELLSEY (RDN, LDN)
Entity type:Individual
Prefix:MS
First Name:KELLSEY
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FIELDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-4371
Mailing Address - Country:US
Mailing Address - Phone:215-692-3696
Mailing Address - Fax:
Practice Address - Street 1:110 FIELDSTONE WAY
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-4371
Practice Address - Country:US
Practice Address - Phone:215-692-3696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006675133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered