Provider Demographics
NPI:1295203081
Name:MEARS, BRIANNA (RD)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:MEARS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:LYN
Other - Last Name:ENGLISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 HIGHLANDER WAY
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-7403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 HIGHLANDER WAY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-7403
Practice Address - Country:US
Practice Address - Phone:603-668-4753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0833133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered