Provider Demographics
NPI:1619718400
Name:EVANS, CHELSEY ALANA (RDN)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:ALANA
Last Name:EVANS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 W 200 S
Mailing Address - Street 2:
Mailing Address - City:LINDON
Mailing Address - State:UT
Mailing Address - Zip Code:84042-1714
Mailing Address - Country:US
Mailing Address - Phone:805-680-8521
Mailing Address - Fax:
Practice Address - Street 1:416 W 200 S
Practice Address - Street 2:
Practice Address - City:LINDON
Practice Address - State:UT
Practice Address - Zip Code:84042-1714
Practice Address - Country:US
Practice Address - Phone:805-680-8521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8906658-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered