Jonathan Brainard, MS, RD, CSSD, CSCS
Dietitian, Registered in Fort Campbell, KY. Individual provider (NPI-1).
NPI number1982309506
StatusActive
Last updated in NPPESJan 30, 2024
Details
- NPI
- 1982309506
- Entity type
- Individual (NPI-1)
- Name
- Jonathan Brainard
- Credential
- MS, RD, CSSD, CSCS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 3, 2023
- Certification date
- Jan 30, 2024
- Last updated
- Jan 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Practice location
7246 Nightstalker WayFort Campbell, KY 42223-5151
Phone 270-798-8727
Mailing address
7246 Nightstalker WayFort Campbell, KY 42223-5151
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All 27 Registered Dietitian providers in Fort Campbell · All 1,373 providers in Fort Campbell
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