Provider Demographics
NPI:1942947189
Name:MAYES, KELSEY EMBER (MSFN, RDN, LD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:EMBER
Last Name:MAYES
Suffix:
Gender:F
Credentials:MSFN, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 TOWNSHIP ROAD 85
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9423
Mailing Address - Country:US
Mailing Address - Phone:419-689-0456
Mailing Address - Fax:
Practice Address - Street 1:8001 RAVINES EDGE CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5423
Practice Address - Country:US
Practice Address - Phone:888-364-5977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program