Provider Demographics
NPI:1508665589
Name:MASTELLER, BRITTANY ALEXIS (RDN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ALEXIS
Last Name:MASTELLER
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ALEXIS
Other - Last Name:PERSICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3790 ROYALE DR
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-9754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3790 ROYALE DR
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-9754
Practice Address - Country:US
Practice Address - Phone:517-331-1596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered