Provider Demographics
NPI:1871790550
Name:CALABRESE, KELLY JOSEPHINE (MS, CPT, CCN)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:JOSEPHINE
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:MS, CPT, CCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5195 SEVENOAKS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-5408
Mailing Address - Country:US
Mailing Address - Phone:719-590-9879
Mailing Address - Fax:
Practice Address - Street 1:5195 SEVENOAKS DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5408
Practice Address - Country:US
Practice Address - Phone:719-590-9879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education