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NPI Code Detail

MEDICARE: MS. KENDAL LENA BJELLA RDN

MEDICARE: MS. KENDAL LENA BJELLA RDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian9379347-4901UT

General Provider Information

NPI Number : 1811773054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KENDAL LENA BJELLA RDN
Provider Business Mailing Address
First Line : PO BOX 30180
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84130-0180
Country : US
Telephone Number : 801-507-7000
Fax Number :
Provider Business Practice Location Address
First Line : 5121 S COTTONWOOD ST
Second Line :
City : MURRAY
State : UT
Zip : 84107-5701
Country : US
Telephone Number : 801-507-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2023
Last Update Date : 06/05/2026

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