Provider Demographics
NPI:1558122150
Name:RAIGN, KELSIE GEE (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:GEE
Last Name:RAIGN
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 1:1870 W BITTERS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1827
Mailing Address - Country:US
Mailing Address - Phone:210-545-4422
Mailing Address - Fax:888-582-7143
Practice Address - Street 1:1870 W BITTERS RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1827
Practice Address - Country:US
Practice Address - Phone:210-545-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88030133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered