Provider Demographics
NPI:1306509880
Name:BRITTON DIABETES & NUTRITION LLC
Entity type:Organization
Organization Name:BRITTON DIABETES & NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD CECES BC-ADM
Authorized Official - Phone:907-268-5585
Mailing Address - Street 1:1200 AIRPORT HEIGHTS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2969
Mailing Address - Country:US
Mailing Address - Phone:907-268-5585
Mailing Address - Fax:907-268-5583
Practice Address - Street 1:11722 LUGENE LN
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7902
Practice Address - Country:US
Practice Address - Phone:907-268-5585
Practice Address - Fax:907-268-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty