MEDICARE: MRS. COURTNEY ANNE MORRISSEY MS, RD, LD

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	133V00000X	Registered Dietitian	1237	SC

General Provider Information

NPI Number	:	1427406024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY ANNE MORRISSEY MS, RD, LD

Provider Business Mailing Address
First Line	:	PO BOX 751461
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1461
Country	:	US
Telephone Number	:	843-792-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 CANNON ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8909
Country	:	US
Telephone Number	:	843-792-9522
Fax Number	:	843-792-8364

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

Provider Enumeration Date	:	05/25/2016
Last Update Date	:	11/10/2016

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