Provider Demographics
NPI:1669341806
Name:MCGILLIVRAY, KELSEY (RDN)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:MCGILLIVRAY
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 1:1160 DAMONTE RANCH PKWY UNIT 3105
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4556
Mailing Address - Country:US
Mailing Address - Phone:775-450-3158
Mailing Address - Fax:
Practice Address - Street 1:1160 DAMONTE RANCH PKWY UNIT 3105
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4556
Practice Address - Country:US
Practice Address - Phone:775-450-3158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty