NPI 1114795432 · live from the CMS NPI Registry
Courtney Broady, RD, LD
Dietitian, Registered in Columbus, OH. National Provider Identifier 1114795432, active.
NPI record
| NPI | 1114795432 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 8001 Ravines Edge Ct, Columbus, OH 43235 |
| Practice phone | 888-364-5977 |
| Mailing address | 1295 Bandana Blvd W,, Ste 210, St Paul, MN 55108 |
| Enumerated | December 15, 2023 |
| Last updated | December 15, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | LD.10379 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.