Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
COURTNEY IWANICKI, MS, RD, CSP
ActivePediatric Nutrition · CLINTON, MI
Registration Details
- NPI Number
- 1891454815
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 17, 2021 (4.3451011295754 yrs)
- Last Updated
- Dec 17, 2021
Practice Information
- Address
-
13733 ALLEN RDCLINTON, MI, 492369653Browse MI providers · Browse ZIP 49236
- Phone
- 2695912464
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.