MEDICARE: DR. BRITTANY NOELLE CRIM PHD, RD, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	DT80859	TX

General Provider Information

NPI Number	:	1265843981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRITTANY NOELLE CRIM PHD, RD, LD

Provider Business Mailing Address
First Line	:	1000 HERITAGE CENTER CIR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-4463
Country	:	US
Telephone Number	:	512-368-7257
Fax Number	:	512-377-9840

Provider Business Practice Location Address
First Line	:	1000 HERITAGE CENTER CIR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-4463
Country	:	US
Telephone Number	:	512-368-7257
Fax Number	:	512-377-9840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	05/15/2014

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