Provider Demographics
NPI:1609994862
Name:KELLY M BARNHILL, CN NNP
Entity type:Organization
Organization Name:KELLY M BARNHILL, CN NNP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARNHILL
Authorized Official - Suffix:
Authorized Official - Credentials:CN CCN
Authorized Official - Phone:512-732-8400
Mailing Address - Street 1:3001 BEE CAVE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5598
Mailing Address - Country:US
Mailing Address - Phone:512-732-8400
Mailing Address - Fax:
Practice Address - Street 1:3001 BEE CAVE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5598
Practice Address - Country:US
Practice Address - Phone:512-732-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00001113133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty