MEDICARE: BREANNA HARR RD, CEDS

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	86107355	CO

General Provider Information

NPI Number	:	1750098893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREANNA HARR RD, CEDS

Provider Business Mailing Address
First Line	:	1366 GARFIELD ST APT 307
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-2740
Country	:	US
Telephone Number	:	720-635-6203
Fax Number	:

Provider Business Practice Location Address
First Line	:	1366 GARFIELD ST APT 307
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-2740
Country	:	US
Telephone Number	:	720-635-6203
Fax Number	:

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

Provider Enumeration Date	:	10/28/2022
Last Update Date	:	10/28/2022

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