Provider Demographics
NPI:1750729703
Name:BROWN, JEFFREY EARL (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:EARL
Last Name:BROWN
Suffix:
Gender:
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 10TH ST NW STE 2346
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-5713
Mailing Address - Country:US
Mailing Address - Phone:301-841-5299
Mailing Address - Fax:
Practice Address - Street 1:6506 AMERICA BLVD
Practice Address - Street 2:UNIT 605
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2091
Practice Address - Country:US
Practice Address - Phone:301-841-5299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD006056133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered