Provider Demographics
NPI:1306717178
Name:LISENBEE, BRIANNA (MS RD LDN)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:LISENBEE
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 1:365 N PICKENS BRIDGE RD APT 114
Mailing Address - Street 2:
Mailing Address - City:PINEY FLATS
Mailing Address - State:TN
Mailing Address - Zip Code:37686-4182
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:365 N PICKENS BRIDGE RD APT 114
Practice Address - Street 2:
Practice Address - City:PINEY FLATS
Practice Address - State:TN
Practice Address - Zip Code:37686-4182
Practice Address - Country:US
Practice Address - Phone:828-691-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000004672133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered