Provider Demographics
NPI:1114776846
Name:THOMPSON, BRIANNE CLAIRE (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:BRIANNE
Middle Name:CLAIRE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7536 TALL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5362
Mailing Address - Country:US
Mailing Address - Phone:954-465-0601
Mailing Address - Fax:
Practice Address - Street 1:7536 TALL OAKS DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5362
Practice Address - Country:US
Practice Address - Phone:954-465-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered