Healthcare Provider Details

I. General information

NPI: 1073431979
Provider Name (Legal Business Name): KOREE LIPTROT MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIDDEN CREEK PL
FLORENCE AL
35630
US

IV. Provider business mailing address

100 HIDDEN CREEK PL APT 112
FLORENCE AL
35630
US

V. Phone/Fax

Practice location:
  • Phone: 470-775-6240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86294109
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: