Provider Demographics
NPI:1891460218
Name:REYE, BRITTANY (NTM)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:REYE
Suffix:
Gender:F
Credentials:NTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 RUSHMORE DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-8607
Mailing Address - Country:US
Mailing Address - Phone:216-802-9636
Mailing Address - Fax:
Practice Address - Street 1:909 RUSHMORE DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-8607
Practice Address - Country:US
Practice Address - Phone:216-802-9636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education