Provider Demographics
NPI:1043859176
Name:KUEBLER, BRANDY JEAN (RDN)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:JEAN
Last Name:KUEBLER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 KNOX AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3739
Mailing Address - Country:US
Mailing Address - Phone:775-815-5448
Mailing Address - Fax:
Practice Address - Street 1:1634 KNOX AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3739
Practice Address - Country:US
Practice Address - Phone:775-815-5448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered