Provider Demographics
NPI:1477987873
Name:HEAPE, BRYNNE JONES (MS,RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:BRYNNE
Middle Name:JONES
Last Name:HEAPE
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 BROWNSBORO RD
Mailing Address - Street 2:APT 11
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1504
Mailing Address - Country:US
Mailing Address - Phone:334-343-2463
Mailing Address - Fax:
Practice Address - Street 1:3015 BROWNSBORO RD
Practice Address - Street 2:APT 11
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1504
Practice Address - Country:US
Practice Address - Phone:334-343-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2437133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered