Healthcare Provider Details

I. General information

NPI: 1982298105
Provider Name (Legal Business Name): ELIZABETH ANN COURTNEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2021
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 ATCHISON ST
ATCHISON KS
66002-2352
US

IV. Provider business mailing address

800 RAVENHILL DR
ATCHISON KS
66002-9204
US

V. Phone/Fax

Practice location:
  • Phone: 913-367-5020
  • Fax: 913-367-1089
Mailing address:
  • Phone: 913-367-2131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-80266-051
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number53-80266
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number13-81206-051
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: