Individual provider · Type 1 NPI

Courtney Ann Provine, CRNP

Acute Care Nurse Practitioner · Philadelphia, PA

NPI number 1497153472 Active

Practice location

3400 Civic Center Blvd, 2 South
Philadelphia, PA 19104

Call (215) 615-0718 Map

Fax (215) 349-8309

Mailing address

5709 Shetland Ct
Bensalem, PA 19020

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner 363LF0000XSP014616 (PA)
Acute Care Nurse Practitioner Primary 363LA2100XSP021617 (PA)

Acute Care Nurse Practitioner: Definition to come...

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About NPI 1497153472

Courtney Ann Provine, CRNP's National Provider Identifier is 1497153472, issued on Dec 8, 2014. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Philadelphia, PA. The record was last updated on Nov 15, 2021.