Provider Demographics
NPI:1689902306
Name:SCHRENKER, BRANDY PAIGE (LDN)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:PAIGE
Last Name:SCHRENKER
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:PAIGE
Other - Last Name:PENNINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 MIDWAY ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-1706
Mailing Address - Country:US
Mailing Address - Phone:423-573-9873
Mailing Address - Fax:423-573-9875
Practice Address - Street 1:28 MIDWAY ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-1706
Practice Address - Country:US
Practice Address - Phone:423-573-9873
Practice Address - Fax:423-573-9875
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1589133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered