Breanna Marie Petrucciani, MS, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

2060 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-6113

Phone

(616) 956-6100

NPI assigned

Feb 18, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1144853144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DWIGHT AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061436",
            "telephone_number": "317-432-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 E PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466113",
            "telephone_number": "616-956-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUCCIANI",
        "first_name": "BREANNA",
        "middle_name": "MARIE",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Anthony Petronio, MD
• Jeremy Bradford Petrous, DO
• Steven Peter Petrovas, M.D.
• Amanda Petrovich
• Jerry Alvin Petrovich, MSW
• Lauren Petruska
• Susanne Pettigrew, PA-C
• Erin Megan Pettijohn, M.D.
• Stuart Pettijohn, DDS
• Jayne Deur Pettinga, NURSE PRACTITIONER

• Registered Dietitian in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Registered Dietitian in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.