Provider Demographics
NPI:1730568585
Name:STRUTHERS, COURTNEY ALANA (CNS)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ALANA
Last Name:STRUTHERS
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N FAYETTE ST APT 634
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2186
Mailing Address - Country:US
Mailing Address - Phone:415-310-9420
Mailing Address - Fax:
Practice Address - Street 1:620 N FAYETTE ST APT 634
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2186
Practice Address - Country:US
Practice Address - Phone:415-310-9420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNU100000175133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist