Provider Demographics
NPI:1215680046
Name:WESELY, TAYLOR MICHELLE (RDN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELLE
Last Name:WESELY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:TAYLOR
Other - Middle Name:MICHELLE
Other - Last Name:SCHUETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:1716 HOOKER ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-1735
Mailing Address - Country:US
Mailing Address - Phone:402-649-6102
Mailing Address - Fax:
Practice Address - Street 1:1716 HOOKER ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1735
Practice Address - Country:US
Practice Address - Phone:402-649-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE86109688133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty