Provider Demographics
NPI:1326561069
Name:PETTY, BRITNEY (RD LD)
Entity Type:Individual
Prefix:
First Name:BRITNEY
Middle Name:
Last Name:PETTY
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:BRITNEY
Other - Middle Name:
Other - Last Name:COWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD LD
Mailing Address - Street 1:2323 INDIAN MOUND LN
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2914
Mailing Address - Country:US
Mailing Address - Phone:785-313-2777
Mailing Address - Fax:
Practice Address - Street 1:1823 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3381
Practice Address - Country:US
Practice Address - Phone:785-776-2886
Practice Address - Fax:785-565-4742
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1935133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered