Provider Demographics
NPI:1235414194
Name:BRITT, BETTY B (RD,LDN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:B
Last Name:BRITT
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 N BRIGHTLEAF BLVD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4407
Mailing Address - Country:US
Mailing Address - Phone:919-989-5200
Mailing Address - Fax:919-989-5200
Practice Address - Street 1:517 N BRIGHTLEAF BLVD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4407
Practice Address - Country:US
Practice Address - Phone:919-989-5200
Practice Address - Fax:919-989-5200
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000060133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL583915OtherCOMMISSION ON DIETETIC REGISTRATION