Provider Demographics
NPI:1881570737
Name:CARROLL, BRITTNEY (MBA, RDN, LDN)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MBA, RDN, LDN
Other - Prefix:
Other - First Name:BEA
Other - Middle Name:
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBA, RDN, LDN
Mailing Address - Street 1:2451 W GRAPEVINE MILLS CIR # 1079
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-2096
Mailing Address - Country:US
Mailing Address - Phone:469-444-0715
Mailing Address - Fax:
Practice Address - Street 1:6415 ROYAL CEDAR DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75236-2518
Practice Address - Country:US
Practice Address - Phone:469-444-0715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT88828133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered