Provider Demographics
NPI:1184507105
Name:BLOUNT, BRANNON ELIZABETH (MS, RDN)
Entity type:Individual
Prefix:
First Name:BRANNON
Middle Name:ELIZABETH
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 OXFORD PL
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-5616
Mailing Address - Country:US
Mailing Address - Phone:434-334-9935
Mailing Address - Fax:
Practice Address - Street 1:5415 W FRIENDLY AVE STE F
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4255
Practice Address - Country:US
Practice Address - Phone:336-790-6778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered