Healthcare Provider Details

I. General information

NPI: 1598527491
Provider Name (Legal Business Name): KELLI FOERSTER MS, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 S GRAMERCY PL APT 107
LOS ANGELES CA
90020-4990
US

IV. Provider business mailing address

519 S GRAMERCY PL APT 107
LOS ANGELES CA
90020-4990
US

V. Phone/Fax

Practice location:
  • Phone: 303-842-5246
  • Fax:
Mailing address:
  • Phone: 303-842-5246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: