Provider Demographics
NPI:1912687609
Name:VELTING, KELLY WOLFE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:WOLFE
Last Name:VELTING
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:KELLY
Other - Middle Name:BROOKE
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1129 UNDERWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-3263
Mailing Address - Country:US
Mailing Address - Phone:616-633-7032
Mailing Address - Fax:
Practice Address - Street 1:1129 UNDERWOOD AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-3263
Practice Address - Country:US
Practice Address - Phone:616-633-7032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered