Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Etemadipour Koppenal, NBCHWC

Individual provider Nutritionist · NPI 1841038858

Kelly Etemadipour Koppenal, NBCHWC is a Nutritionist in Goode, Virginia. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
3

Practice location Address checks out

203 Longhill Rd
Goode, VA 24556-2209
Phone: (973) 885-3709
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health & Wellness Coach (primary) Taxonomy 171400000X · Licence A-3650883
Nutritionist Taxonomy 133N00000X
Nutrition Education Nutritionist Taxonomy 133NN1002X

Record details

NPI number1841038858
Entity typeIndividual (Type 1)
GenderFemale
Credentials NBCHWC
Sole proprietorYes
NPI enumeratedJuly 16, 2024
Last updated in NPPESJuly 16, 2024
Certification dateJuly 16, 2024