Provider Demographics
NPI:1316738743
Name:BRAINERD, ASHLEY (RD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BRAINERD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11566 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-8001
Mailing Address - Country:US
Mailing Address - Phone:734-645-3769
Mailing Address - Fax:
Practice Address - Street 1:11566 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-8001
Practice Address - Country:US
Practice Address - Phone:734-645-3769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered