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General NPI Number Information
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NPI Number | 1760121685
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Entity Type | Individual
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Provider Name | KAILYN MARIE HELGESON NUTRITIONIST
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 444 S RAND RD STE 211
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City | LAKE ZURICH
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State | IL
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Zip | 60047-2307
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Country | US
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Telephone | 224-475-1223
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Fax |
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Provider Business Mailing Address
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Address Line | 2277 QUARRY LN
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City | ONALASKA
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State | WI
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Zip | 54650-8433
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Country | US
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Telephone | 608-386-8456
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 10549
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License Number State | WI
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