Provider Demographics
NPI:1891885992
Name:METZGER, KELLI MICHELE (MS, RD, LDN, CDE)
Entity Type:Individual
Prefix:MS
First Name:KELLI
Middle Name:MICHELE
Last Name:METZGER
Suffix:
Gender:F
Credentials:MS, RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5911 LEBANON LN
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5142
Mailing Address - Country:US
Mailing Address - Phone:919-986-2508
Mailing Address - Fax:
Practice Address - Street 1:2150 PENNSYLVANIA AVE, NW, SUITE 4-417
Practice Address - Street 2:GW HEART AND VASCULAR INSTITUTE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-741-2579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDO2218133V00000X
DCD1100000590133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered