Provider Demographics
NPI:1932729811
Name:BROWN, REBECCA LYNN (RDN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 S LITTLE RIVER WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2502
Mailing Address - Country:US
Mailing Address - Phone:303-355-4745
Mailing Address - Fax:
Practice Address - Street 1:5999 S LITTLE RIVER WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-2502
Practice Address - Country:US
Practice Address - Phone:720-207-8734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO926433133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist