Healthcare Provider Details

I. General information

NPI: 1891101564
Provider Name (Legal Business Name): KELSEY ZVEJNIEKS MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N WYATT DR
TUCSON AZ
85712-6106
US

IV. Provider business mailing address

2518 E HEDRICK DR
TUCSON AZ
85716-1558
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-5437
  • Fax:
Mailing address:
  • Phone: 605-467-0206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: