Healthcare Provider Details

I. General information

NPI: 1447606827
Provider Name (Legal Business Name): JENNIFER LEE BRINDLEY RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 07/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 4TH AVE N STE 104
NASHVILLE TN
37219-2400
US

IV. Provider business mailing address

162 4TH AVE N STE 104
NASHVILLE TN
37219-2400
US

V. Phone/Fax

Practice location:
  • Phone: 615-474-5753
  • Fax:
Mailing address:
  • Phone: 615-474-5753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number3039
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number3039
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3039
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number3039
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number3039
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: