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General NPI Number Information
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NPI Number | 1134913908
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Entity Type | Individual
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Provider Name | KELSEY COATES BSN, RDN, BPC
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Gender | Female
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 7530 WILDEMERE ST
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City | DETROIT
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State | MI
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Zip | 48206-2563
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Country | US
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Telephone | 313-573-3175
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Fax |
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Provider Business Mailing Address
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Address Line | 7530 WILDEMERE ST
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City | DETROIT
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State | MI
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Zip | 48206-2563
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Country | US
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Telephone | 313-573-3175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 86331398
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 86331398
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | 86331398
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License Number State |
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86331398
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License Number State |
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