Provider Demographics
NPI:1235911124
Name:WOODSON, KELSEY (RDN)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:WOODSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 SW KESSLER DR UNIT 7008
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2277
Mailing Address - Country:US
Mailing Address - Phone:913-620-2052
Mailing Address - Fax:
Practice Address - Street 1:6801 W 121ST ST STE 121
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2005
Practice Address - Country:US
Practice Address - Phone:816-695-8245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered