Provider Demographics
NPI:1366062010
Name:HEALTHY WEIGHT NUTRITION
Entity type:Organization
Organization Name:HEALTHY WEIGHT NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:WEST
Authorized Official - Last Name:KEYSER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD, CDE
Authorized Official - Phone:205-213-0410
Mailing Address - Street 1:5361 MEADOW BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3340
Mailing Address - Country:US
Mailing Address - Phone:205-213-0410
Mailing Address - Fax:251-299-4030
Practice Address - Street 1:5361 MEADOW BROOK RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-3340
Practice Address - Country:US
Practice Address - Phone:205-213-0410
Practice Address - Fax:251-299-4030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty