Healthcare Provider Details

I. General information

NPI: 1972198950
Provider Name (Legal Business Name): KELLY WESTBROOK MS, RDN, LD, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY KADING

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 FILLMORE ST UNIT 150
DENVER CO
80206-5001
US

IV. Provider business mailing address

20254 GOINS DR
MORRISON CO
80465-2326
US

V. Phone/Fax

Practice location:
  • Phone: 512-693-7045
  • Fax: 512-399-9039
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number316916
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD.09357
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86026461
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: