Provider Demographics
NPI:1801228457
Name:MCCURDY, BRETT A (RD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:A
Last Name:MCCURDY
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 S FEDERAL WAY # MS 1-706
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-9632
Mailing Address - Country:US
Mailing Address - Phone:208-368-5656
Mailing Address - Fax:208-368-5607
Practice Address - Street 1:8000 S FEDERAL WAY # MS 1-706
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83716-9632
Practice Address - Country:US
Practice Address - Phone:208-368-5656
Practice Address - Fax:208-368-5607
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered