Provider Demographics
NPI:1053389494
Name:CURTIS, HELEN LOUISE (RD LDN CDE)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:LOUISE
Last Name:CURTIS
Suffix:
Gender:F
Credentials:RD LDN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1657
Mailing Address - Street 2:
Mailing Address - City:INTERLACHEN
Mailing Address - State:FL
Mailing Address - Zip Code:32148-1657
Mailing Address - Country:US
Mailing Address - Phone:386-546-5732
Mailing Address - Fax:888-391-3648
Practice Address - Street 1:6050 SAINT JOHNS AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3895
Practice Address - Country:US
Practice Address - Phone:386-546-5732
Practice Address - Fax:888-391-3648
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
818166133V00000X
FLND 2522133VN1006X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
Provider Identifiers
StateIdentifier IDID TypeIssuer
U3822ZMedicare UPIN