MEDICARE: DENISE DEWHURST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1184572984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE DEWHURST

Provider Business Mailing Address
First Line	:	10232 BRISTOL CHANNEL
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-5818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10232 BRISTOL CHANNEL
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-5818
Country	:	US
Telephone Number	:	646-263-3812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “ DENISE DEWHURST ” Practice Location

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