Healthcare Provider Details

I. General information

NPI: 1346739034
Provider Name (Legal Business Name): MARY CURNUTTE MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 LILY CREEK RD STE 201
LOUISVILLE KY
40243-2815
US

IV. Provider business mailing address

1012 S SHELBY ST
LOUISVILLE KY
40203-3414
US

V. Phone/Fax

Practice location:
  • Phone: 502-338-0608
  • Fax:
Mailing address:
  • Phone: 502-435-1359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: