Healthcare Provider Details

I. General information

NPI: 1730568585
Provider Name (Legal Business Name): COURTNEY ALANA STRUTHERS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N FAYETTE ST APT 634
ALEXANDRIA VA
22314-2186
US

IV. Provider business mailing address

620 N FAYETTE ST APT 634
ALEXANDRIA VA
22314-2186
US

V. Phone/Fax

Practice location:
  • Phone: 415-310-9420
  • Fax:
Mailing address:
  • Phone: 415-310-9420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU100000175
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: