Provider Demographics
NPI:1497084271
Name:BARNABY, KELLY (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:BARNABY
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:HEART FAILURE AND CARDIOMYOPATHY PROGRAM
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-0001
Mailing Address - Country:US
Mailing Address - Phone:603-650-2929
Mailing Address - Fax:603-650-0607
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:HEART FAILURE AND CARDIOMYOPATHY PROGRAM
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-2929
Practice Address - Fax:603-650-0607
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0559133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0559OtherNH LICENSE NUMBER
NH966567OtherREGISTRATION NUMBER