Healthcare Provider Details

I. General information

NPI: 1184277394
Provider Name (Legal Business Name): COURTNEY GREENUP NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9137 RIDGELINE BLVD STE 100
HIGHLANDS RANCH CO
80129-2397
US

IV. Provider business mailing address

9137 RIDGELINE BLVD STE 100
HIGHLANDS RANCH CO
80129-2397
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-3140
  • Fax: 303-649-3154
Mailing address:
  • Phone: 303-649-3140
  • Fax: 303-649-3154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0997589-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95012251
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: