Provider Demographics
NPI:1285028613
Name:SPEARSON, COURTNEY (MS)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SPEARSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 STILLWOODS WAY
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-4655
Mailing Address - Country:US
Mailing Address - Phone:240-475-3992
Mailing Address - Fax:
Practice Address - Street 1:1245 STILLWOODS WAY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-4655
Practice Address - Country:US
Practice Address - Phone:240-475-3992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education