Provider Demographics
NPI:1871163766
Name:HERMAN, GRACE BRINSON (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:BRINSON
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ELIZABETH
Other - Last Name:BRINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 APPALACHIAN ST STE EE
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4579
Mailing Address - Country:US
Mailing Address - Phone:828-333-0096
Mailing Address - Fax:
Practice Address - Street 1:140 APPALACHIAN ST STE EE
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4579
Practice Address - Country:US
Practice Address - Phone:828-333-0096
Practice Address - Fax:828-505-8772
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty