Provider Demographics
NPI:1700531332
Name:LINDLY, BRYANNA S (FDN-P)
Entity Type:Individual
Prefix:
First Name:BRYANNA
Middle Name:S
Last Name:LINDLY
Suffix:
Gender:F
Credentials:FDN-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2858 DEL LOMA DR
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-5705
Mailing Address - Country:US
Mailing Address - Phone:408-892-7170
Mailing Address - Fax:
Practice Address - Street 1:2858 DEL LOMA DR
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-5705
Practice Address - Country:US
Practice Address - Phone:408-892-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education