Healthcare Provider Details

I. General information

NPI: 1932729811
Provider Name (Legal Business Name): REBECCA LYNN BROWN RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5999 S LITTLE RIVER WAY
AURORA CO
80016-2502
US

IV. Provider business mailing address

5999 S LITTLE RIVER WAY
AURORA CO
80016-2502
US

V. Phone/Fax

Practice location:
  • Phone: 720-207-8734
  • Fax:
Mailing address:
  • Phone: 303-355-4745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number926433
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: