Provider Demographics
NPI:1427406024
Name:MORRISSEY, COURTNEY ANNE (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ANNE
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:135 CANNON ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8909
Practice Address - Country:US
Practice Address - Phone:843-792-9522
Practice Address - Fax:843-792-8364
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1237133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered