Provider Demographics
NPI:1407181290
Name:MCCARTY, COURTNEY A (RD, LD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-3702
Mailing Address - Country:US
Mailing Address - Phone:785-460-4849
Mailing Address - Fax:785-460-4870
Practice Address - Street 1:1230 LUE DR
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2814
Practice Address - Country:US
Practice Address - Phone:785-460-4849
Practice Address - Fax:785-460-4870
Is Sole Proprietor?:No
Enumeration Date:2009-10-12
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1553133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered