Provider Demographics
NPI:1437655735
Name:BROWN, JILL ANN (MS RD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:122 COSGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5267
Mailing Address - Country:US
Mailing Address - Phone:828-318-4221
Mailing Address - Fax:919-948-2383
Practice Address - Street 1:122 COSGROVE AVE
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5267
Practice Address - Country:US
Practice Address - Phone:828-318-4221
Practice Address - Fax:919-948-2383
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1755133V00000X
NCL005425133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered