Provider Demographics
NPI:1063137594
Name:SINN, BRIANNA MARIE (RD)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:SINN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15399 ROAD 48
Mailing Address - Street 2:
Mailing Address - City:HAVILAND
Mailing Address - State:OH
Mailing Address - Zip Code:45851-9709
Mailing Address - Country:US
Mailing Address - Phone:419-786-9789
Mailing Address - Fax:
Practice Address - Street 1:15399 ROAD 48
Practice Address - Street 2:
Practice Address - City:HAVILAND
Practice Address - State:OH
Practice Address - Zip Code:45851-9709
Practice Address - Country:US
Practice Address - Phone:419-786-9789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09746133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered