NPI 1184214108

Brianna Kay Wynne, MSRDLDN

Practitioner Registered Dietitian Mokena, IL

Practice location

Address: 19805 S La Grange Rd, Mokena, IL 60448-8348
Phone: (708) 938-3378
Mailing address: 629 W Deming Pl, Chicago, IL 60614-2693

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 164007804 (IL)

Other Dietitian, Registered providers in Illinois →

Registry record

NPI: 1184214108
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Jan 2021
Record last updated: 23 Jan 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.