Provider Demographics
NPI:1265103378
Name:BRUNO, KELSI (RD)
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:
Last Name:BRUNO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9122 HOBBIT CIR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-8413
Mailing Address - Country:US
Mailing Address - Phone:619-433-2542
Mailing Address - Fax:
Practice Address - Street 1:200 MICHIGAN AVE W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3607
Practice Address - Country:US
Practice Address - Phone:269-888-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered