Provider Demographics
NPI:1477265981
Name:WINFREE, BRANDY LYNN (RD, CSR, LDN)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:LYNN
Last Name:WINFREE
Suffix:
Gender:F
Credentials:RD, CSR, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 EMERALD POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MARY ESTHER
Mailing Address - State:FL
Mailing Address - Zip Code:32569-2767
Mailing Address - Country:US
Mailing Address - Phone:318-210-6429
Mailing Address - Fax:
Practice Address - Street 1:410 EMERALD POINTE DR
Practice Address - Street 2:
Practice Address - City:MARY ESTHER
Practice Address - State:FL
Practice Address - Zip Code:32569-2767
Practice Address - Country:US
Practice Address - Phone:318-210-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND10904133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal