MEDICARE: BRITTAN DONOHOE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1174400832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRITTAN DONOHOE INC

Provider Business Mailing Address
First Line	:	3920 PORTLAND AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-2523
Country	:	US
Telephone Number	:	507-382-0357
Fax Number	:

Provider Business Practice Location Address
First Line	:	3920 PORTLAND AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-2523
Country	:	US
Telephone Number	:	507-382-0357
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRITTAN DONOHOE
Credential	:	RD, LD
Telephone Number	:	507-382-0357

Provider Enumeration Date	:	08/16/2025
Last Update Date	:	08/16/2025

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