Provider Demographics
NPI:1841678786
Name:THORNTON, BRIANNE C (RD)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:C
Last Name:THORNTON
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:C
Other - Last Name:GOHLKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CD
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:608-829-5485
Mailing Address - Fax:
Practice Address - Street 1:1102 S PARK ST STE 200
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1708
Practice Address - Country:US
Practice Address - Phone:608-263-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2728-29133V00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No171400000XOther Service ProvidersHealth & Wellness Coach