Healthcare Provider Details

I. General information

NPI: 1467142000
Provider Name (Legal Business Name): KELLY LEANNE BARTH RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 S ONEIDA ST APT A
DENVER CO
80224-3134
US

IV. Provider business mailing address

1175 S ONEIDA ST APT A
DENVER CO
80224-3134
US

V. Phone/Fax

Practice location:
  • Phone: 614-256-4775
  • Fax:
Mailing address:
  • Phone: 614-256-4775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86254320
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: