Provider Demographics
NPI:1609573104
Name:GILVIN, BRITTANY (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:GILVIN
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:LOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, LDN
Mailing Address - Street 1:3172 BRUNSWICK FOREST CIR W
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2144
Mailing Address - Country:US
Mailing Address - Phone:419-575-0734
Mailing Address - Fax:
Practice Address - Street 1:7008 E SHELBY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-3416
Practice Address - Country:US
Practice Address - Phone:901-757-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4039133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered