# BRAZEN WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316804164
- **Authorized official:** JENNIFER D JOHNSON (MEMBER)
- **Authorized official phone:** (678) 234-3328

## Contact information

- **Practice address:** 3144 ROCK PORT CIR, PEACHTREE CORNERS, GA 30092-2738
- **Practice address phone:** (678) 234-3328
- **Mailing address:** 3144 ROCK PORT CIR, PEACHTREE CORNERS, GA 30092-2738
- **Mailing address phone:** (678) 234-3328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | — | NULL | — |
| 133N00000X | Nutritionist | — | — | — |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | — |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | — |
| 226300000X | Kinesiotherapist | — | NULL | — |
| 226300000X | Kinesiotherapist | — | — | — |

## Other

- **Enumeration date:** 01/05/2026
- **Last updated:** 01/05/2026