Provider Demographics
NPI:1073010088
Name:BROSNAN, KATHARINE (RDN)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:BROSNAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 BARBARA DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-4311
Mailing Address - Country:US
Mailing Address - Phone:865-548-6477
Mailing Address - Fax:
Practice Address - Street 1:4310 BARBARA DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-4311
Practice Address - Country:US
Practice Address - Phone:865-548-6477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-07
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2038133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered