Provider Demographics
NPI:1184290215
Name:KURZONTKOWSKI, CHELCIE ALLAN (MS, RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:CHELCIE
Middle Name:ALLAN
Last Name:KURZONTKOWSKI
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:CHELCIE
Other - Middle Name:ALLANNE
Other - Last Name:MURAGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-1959
Practice Address - Fax:252-744-1200
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-30
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006336133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered