Kelly Petersen is one of 300 dietitians and nutrition professionals practicing in Austin, Texas .
Kelly Petersen practices with Nourish, Inc.
Registry record (NPPES)
NPI
1407637101
Type
Type 1 · Individual
Primary taxonomy
Dietitian, Registered · 133V00000X
Address on file
841 McKay St
Enumerated
Oct 9, 2023
Record last updated
Oct 9, 2023
Medicare (CMS)
Enrollment
Medicare-enrolled in TXRegistered Dietitian or Nutrition Professional
Revalidation due
No date set by CMS
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Part D prescribing
Procedure volumes by CPT code
Group affiliations and colleagues
Full enrollment history
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Practice locations
3724 Jefferson St Suite 104Austin , TX 78731
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Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.
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