Provider Demographics
NPI:1124631759
Name:BRECHEEN, BRITTA AMBER (RD)
Entity type:Individual
Prefix:MRS
First Name:BRITTA
Middle Name:AMBER
Last Name:BRECHEEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92241
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99509-2241
Mailing Address - Country:US
Mailing Address - Phone:907-317-4944
Mailing Address - Fax:
Practice Address - Street 1:3403 LOIS DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2000
Practice Address - Country:US
Practice Address - Phone:907-317-4944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11892875-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered