Provider Demographics
NPI:1578343877
Name:BIRD, BRITTNY LYNNE (RDN)
Entity Type:Individual
Prefix:
First Name:BRITTNY
Middle Name:LYNNE
Last Name:BIRD
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8349 S 1050 E
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-0717
Mailing Address - Country:US
Mailing Address - Phone:801-380-1834
Mailing Address - Fax:
Practice Address - Street 1:1389 W 9000 S
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9269
Practice Address - Country:US
Practice Address - Phone:801-380-1834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT977096133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered