Healthcare Provider Details

I. General information

NPI: 1013621259
Provider Name (Legal Business Name): SAVANNAH BRITTANY DUFFY MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 JOHNSON FY RD NE STE 350
ATLANTA GA
30342-1740
US

IV. Provider business mailing address

16055 WESTBROOK RD
MILTON GA
30004-2887
US

V. Phone/Fax

Practice location:
  • Phone: 404-236-8036
  • Fax:
Mailing address:
  • Phone: 770-510-8986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD005880
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: