MEDICARE: BRANNER LLC

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	:	1639981079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANNER LLC

Provider Business Mailing Address
First Line	:	720 SILVER SPRINGS DR
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-5119
Country	:	US
Telephone Number	:	615-481-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 SILVER SPRINGS DR
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-5119
Country	:	US
Telephone Number	:	615-481-3061
Fax Number	:

Authorized Official
Title or Position	:	OWNER, DIETITIAN
Name	:	MR. CHRISTOPHER A BRANNER
Credential	:	RDN, LDN
Telephone Number	:	615-481-3061

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	01/23/2025

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