Provider Demographics
NPI:1952016826
Name:DIENER, COURTNEY MARIE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:MARIE
Last Name:DIENER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:MARIE
Other - Last Name:WING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:20 YEATES DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720
Mailing Address - Country:US
Mailing Address - Phone:302-521-3635
Mailing Address - Fax:
Practice Address - Street 1:20 YEATES DRIVE
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720
Practice Address - Country:US
Practice Address - Phone:302-521-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN-0000638133V00000X
86100022133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered