Courtney Lyn Weese, RD
Individual provider Active NPI Registered Dietitian · Mantua, UT
NPI 1851199954 · NPPES record last updated Mar 4, 2025
Key facts
- NPI
- 1851199954
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- Practice address
- 569 S Lake View Dr
Mantua, UT 84324-4423 - Phone
- (928) 231-1619
- NPI assigned
- Mar 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Yes |
Addresses
Primary practice location
569 S Lake View Dr
Mantua, UT 84324-4423
Mailing address
569 S Lake View Dr
Mantua, UT 84324-4423
Phone (928) 231-1619
Other providers in Mantua, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.