Individual
KOURTNEY PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1331 S ADAMS ST APT 8, BLOOMINGTON, IN 47403-2198
(812) 562-0757
Mailing address
1331 S ADAMS ST APT 8, BLOOMINGTON, IN 47403-2198
(812) 562-0757
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37003297A
IN
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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