Provider Demographics
NPI:1972198950
Name:WESTBROOK, KELLY (MS, RDN, LD, CLC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:MS, RDN, LD, CLC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:KADING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20254 GOINS DR
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-2326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 FILLMORE ST UNIT 150
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5001
Practice Address - Country:US
Practice Address - Phone:512-693-7045
Practice Address - Fax:512-399-9039
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO316916174N00000X
OHLD.09357133V00000X
CO86026461133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN