Provider Demographics
NPI:1659093938
Name:BOLIN, BRITTNEY (CFNC, CNC, WLS, BCS)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:BOLIN
Suffix:
Gender:F
Credentials:CFNC, CNC, WLS, BCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7995 FULMONT DR
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-3796
Mailing Address - Country:US
Mailing Address - Phone:804-456-6609
Mailing Address - Fax:
Practice Address - Street 1:7995 FULMONT DR
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-3796
Practice Address - Country:US
Practice Address - Phone:804-456-6609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA133NN1002X, 171400000X
VA1200527544133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach