Healthcare Provider Details

I. General information

NPI: 1053438085
Provider Name (Legal Business Name): COURTNEY RENEE ALBRITTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 1ST AVE NE
CEDAR RAPIDS IA
52402-5433
US

IV. Provider business mailing address

1700 1ST AVE NE
CEDAR RAPIDS IA
52402-5433
US

V. Phone/Fax

Practice location:
  • Phone: 319-821-1318
  • Fax: 319-575-6105
Mailing address:
  • Phone: 319-821-1318
  • Fax: 319-575-6105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number001801
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number001801
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001801
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: