Individual
AMY M BRAGAGNINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
630 KENMOOR AVE SE, SUITE 103, GRAND RAPIDS, MI 49546
(616) 600-4950
(855) 817-3028
Mailing address
630 KENMOOR AVE SE, SUITE 103, GRAND RAPIDS, MI 49546
(203) 688-2422
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
1439
CT
133V00000X
Registered Dietitian
Primary
886364
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02658
YNHH MEDICARE NUMBER
CT
Enumeration date
09/07/2016
Last updated
09/20/2023
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