Amber Lynn Conner, MS, RDN, LDN

Individual provider Active NPI Sports Dietetics Nutrition Registered Dietitian · Brookhaven, PA

NPI 1033939210 · NPPES record last updated Oct 14, 2024

Key facts

NPI
1033939210
Entity type
Individual (NPI type 1)
Primary specialty
Sports Dietetics Nutrition Registered Dietitian 133VN1501X
License
86392701 (PA)
Practice address
249 Charles Ave
Brookhaven, PA 19015-2706
Phone
(610) 570-8121
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86392701PAMDSports Dietetics Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X 86392701 PA Yes

Addresses

Primary practice location

249 Charles Ave
Brookhaven, PA 19015-2706

Mailing address

249 Charles Ave
Brookhaven, PA 19015-2706
Phone (610) 570-8121

Other providers in Brookhaven, PA

All providers in Brookhaven, PA · Sports Dietetics Nutrition Registered Dietitian in Pennsylvania

Sources for this page

Verify at the official NPI Registry.