Provider Demographics
NPI:1164311601
Name:BRANTLEY, EILEEN S (FNTP, MS, CNS-CAN)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:S
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:FNTP, MS, CNS-CAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:73 BEAVERDAM CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30683-2720
Mailing Address - Country:US
Mailing Address - Phone:615-714-8197
Mailing Address - Fax:
Practice Address - Street 1:73 BEAVERDAM CREEK RD
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:GA
Practice Address - Zip Code:30683-2720
Practice Address - Country:US
Practice Address - Phone:615-714-8197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education