Healthcare Provider Details
I. General information
NPI: 1396382958
Provider Name (Legal Business Name): BRITTANY LYNN MCCLAY RDN, CSSD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/03/2019
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US
IV. Provider business mailing address
1650 COCHRANE CIRCLE EACH
FORT CARSON CO
80913
US
V. Phone/Fax
- Phone: 719-526-9666
- Fax:
- Phone: 719-526-9666
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 86099491 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133VN1501X |
| Taxonomy | Sports Dietetics Nutrition Registered Dietitian |
| License Number | 86099491 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: