Provider Demographics
NPI:1396393997
Name:SCHIFERL, KELSEY LYNN (MS, RDN)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:LYNN
Last Name:SCHIFERL
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:LYNN
Other - Last Name:KOMISAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN
Mailing Address - Street 1:36065 SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36065 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5060
Practice Address - Country:US
Practice Address - Phone:254-533-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program