Individual
JENNIFER BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
307 E 12TH ST, BENTON, KY 42025-1525
(270) 527-1496
(270) 527-5321
Mailing address
307 E 12TH ST, PO BOX 607, BENTON, KY 42025-1525
(270) 527-1496
(270) 527-5321
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20079018
—
KY
05
—
20079026
—
KY
Enumeration date
06/03/2008
Last updated
06/03/2008
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