MEDICARE: BRIANNA LISENBEE MS RD LDN

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	LDN0000004672	TN

General Provider Information

NPI Number	:	1306717178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA LISENBEE MS RD LDN

Provider Business Mailing Address
First Line	:	115 REED RD
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-2738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 REED RD
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-2738
Country	:	US
Telephone Number	:	828-691-9015
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	05/28/2026

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