Provider Demographics
NPI:1114789690
Name:LAMANNA, COURTNEY ANNE (RD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ANNE
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7853 E 123RD PL
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8283
Mailing Address - Country:US
Mailing Address - Phone:719-431-2674
Mailing Address - Fax:
Practice Address - Street 1:7853 E 123RD PL
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-8283
Practice Address - Country:US
Practice Address - Phone:719-431-2674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered