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General NPI Number Information
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NPI Number | 1215318720
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Entity Type | Individual
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Provider Name | KRISTAN STEWART BROWN R.D.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 200 PATEWOOD DR STE A140
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City | GREENVILLE
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State | SC
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Zip | 29615-3585
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Country | US
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Telephone | 864-454-5125
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Fax | 864-241-9201
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-522-8603
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 1224
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1224
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License Number State | SC
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