Provider Demographics
NPI:1134645153
Name:STINSON, COURTNEY (RDN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:STINSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8580 ACORNE AVE
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MI
Mailing Address - Zip Code:48160-9509
Mailing Address - Country:US
Mailing Address - Phone:734-395-8469
Mailing Address - Fax:
Practice Address - Street 1:8580 ACORNE AVE
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-9509
Practice Address - Country:US
Practice Address - Phone:734-395-8469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI976164133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered