Provider Demographics
NPI:1942865514
Name:DELPRA, COURTNEY NICOLE (RD)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:NICOLE
Last Name:DELPRA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:COURTNEY
Other - Middle Name:NICOLE
Other - Last Name:BARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:80 PALOMINO LANE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110
Mailing Address - Country:US
Mailing Address - Phone:888-964-1975
Mailing Address - Fax:603-606-1032
Practice Address - Street 1:37903 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-5978
Practice Address - Country:US
Practice Address - Phone:888-964-1975
Practice Address - Fax:603-606-1032
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08241133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered