Provider Demographics
NPI:1124269402
Name:NELSON, BRITTANEE (RD)
Entity type:Individual
Prefix:MRS
First Name:BRITTANEE
Middle Name:
Last Name:NELSON
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 1:1020 HIGH RD
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:IN
Mailing Address - Zip Code:46506-1093
Mailing Address - Country:US
Mailing Address - Phone:574-546-8016
Mailing Address - Fax:574-546-4312
Practice Address - Street 1:1020 HIGH RD
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:IN
Practice Address - Zip Code:46506-1093
Practice Address - Country:US
Practice Address - Phone:574-546-8016
Practice Address - Fax:574-546-4312
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN370019001A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered