Healthcare Provider Details

I. General information

NPI: 1750978318
Provider Name (Legal Business Name): ANNE BRENDLE MS, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 ARIZONA AVE NE
ATLANTA GA
30307-2248
US

IV. Provider business mailing address

195 ARIZONA AVE NE STE 400
ATLANTA GA
30307-2248
US

V. Phone/Fax

Practice location:
  • Phone: 404-808-8639
  • Fax:
Mailing address:
  • Phone: 404-808-8639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: