Provider Demographics
NPI:1437839107
Name:TEMPLEMAN, KELLY (MPH,CHES, NBC-HWC)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:TEMPLEMAN
Suffix:
Gender:F
Credentials:MPH,CHES, NBC-HWC
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:TEMPLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1578 CREVASSE CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4807
Mailing Address - Country:US
Mailing Address - Phone:949-579-0551
Mailing Address - Fax:
Practice Address - Street 1:1578 CREVASSE CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4807
Practice Address - Country:US
Practice Address - Phone:949-579-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator