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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KELLY ETEMADIPOUR KOPPENAL, NBCHWC

Active Sole Proprietor

Health & Wellness Coach · GOODE, VA

Registration Details

NPI Number
1841038858
Provider Type
Individual
Gender
Female
NPI Issued
Jul 16, 2024 (1.8055744487085 yrs)
Last Updated
Jul 16, 2024
License
A-3650883
Sole Proprietor
Yes

Practice Information

Address
203 LONGHILL RD
GOODE, VA, 245562209
Browse VA providers · Browse ZIP 24556
Phone
9738853709
Primary Specialty
Health & Wellness Coach
171400000X
Additional Specialty
Nutrition, Education
Additional Specialty
Health & Wellness Coach
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.