Provider Demographics
NPI:1689290090
Name:BROWNLEE, DEVON AMANDA (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:AMANDA
Last Name:BROWNLEE
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W CANAL ST APT 502
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2136
Mailing Address - Country:US
Mailing Address - Phone:802-249-7884
Mailing Address - Fax:
Practice Address - Street 1:373 BLAIR PARK RD UNIT 100
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-8077
Practice Address - Country:US
Practice Address - Phone:802-391-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered