Provider Demographics
NPI:1710616487
Name:DUNN, BRYNNA ALEXIS (RDN, LD)
Entity Type:Individual
Prefix:
First Name:BRYNNA
Middle Name:ALEXIS
Last Name:DUNN
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W CHASE LN
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-1442
Mailing Address - Country:US
Mailing Address - Phone:801-633-1606
Mailing Address - Fax:
Practice Address - Street 1:5405 TUCKERMAN LN APT 727
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-7328
Practice Address - Country:US
Practice Address - Phone:801-633-6106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86077828133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered