Amanda Rose Brainerd, RD

Individual provider Active NPI Obesity and Weight Management Nutrition Registered Dietitian · De Witt, IA

NPI 1992408702 · NPPES record last updated Mar 22, 2023

Key facts

NPI
1992408702
Entity type
Individual (NPI type 1)
Primary specialty
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X
Practice address
1614 15TH Ave
De Witt, IA 52742-1087
Phone
(563) 221-1315
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X Yes

Addresses

Primary practice location

1614 15TH Ave
De Witt, IA 52742-1087

Mailing address

12605 Ventura Blvd # 1024
Studio City, CA 91604-2415

Other providers in De Witt, IA

All providers in De Witt, IA · Obesity and Weight Management Nutrition Registered Dietitian in Iowa

Sources for this page

Verify at the official NPI Registry.