Provider Demographics
NPI:1104673045
Name:BRASWELL, KATHERINE (MS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BRASWELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 US 127
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-7650
Mailing Address - Country:US
Mailing Address - Phone:770-655-9616
Mailing Address - Fax:
Practice Address - Street 1:767 US 127
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-7650
Practice Address - Country:US
Practice Address - Phone:770-655-9616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist