Provider Demographics
NPI:1063215192
Name:SPENCER, COURTNEY (RD, LDN)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SPENCER
Suffix:
Gender:
Credentials:RD, LDN
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:NICOLE
Other - Last Name:BRASSEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:950 AMETHYST ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3606
Mailing Address - Country:US
Mailing Address - Phone:985-502-9992
Mailing Address - Fax:
Practice Address - Street 1:950 AMETHYST ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3606
Practice Address - Country:US
Practice Address - Phone:985-502-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2383133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered