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NPI Code Detail

MEDICARE: KELLY WESTBROOK MS, RDN, LD, CLC

MEDICARE: KELLY WESTBROOK MS, RDN, LD, CLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174N00000XLactation Consultant (Non-RN)316916CO
2133V00000XRegistered DietitianLD.09357OH
3133V00000XRegistered Dietitian86026461CO

General Provider Information

NPI Number : 1972198950
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY WESTBROOK MS, RDN, LD, CLC
Provider Business Mailing Address
First Line : 20254 GOINS DR
Second Line :
City : MORRISON
State : CO
Zip : 80465-2326
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 250 FILLMORE ST UNIT 150
Second Line :
City : DENVER
State : CO
Zip : 80206-5001
Country : US
Telephone Number : 512-693-7045
Fax Number : 512-399-9039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2021
Last Update Date : 09/08/2025

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