Provider Demographics
NPI:1033376488
Name:THOMPSON, BREE ANN (MS, RD)
Entity Type:Individual
Prefix:
First Name:BREE
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 W GRANT RANCH BLVD
Mailing Address - Street 2:927
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-0613
Mailing Address - Country:US
Mailing Address - Phone:720-935-3412
Mailing Address - Fax:
Practice Address - Street 1:SOUTHERN AZ VA HEALTH CARE SYSTEM
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-0001
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO964671133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO964671OtherCOMMISSION ON DIETETIC REGISTRATION