Healthcare Provider Details

I. General information

NPI: 1649393638
Provider Name (Legal Business Name): COURTNEY ANNE WHITSON RN, MSN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 PARNASSUS AVE # U585
SAN FRANCISCO CA
94143-2208
US

IV. Provider business mailing address

3501 LAGUNA ST APT 204
SAN FRANCISCO CA
94123-2289
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2423
  • Fax:
Mailing address:
  • Phone: 530-848-0507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number16775
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number2577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: