Provider Demographics
NPI:1295431039
Name:DORR, BRIANNE (RD)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:DORR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:
Other - Last Name:VERRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:200 CHINQUAPIN ORCH
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-2323
Mailing Address - Country:US
Mailing Address - Phone:660-441-7047
Mailing Address - Fax:
Practice Address - Street 1:200 CHINQUAPIN ORCH
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-2323
Practice Address - Country:US
Practice Address - Phone:660-441-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI796133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered