Healthcare Provider Details

I. General information

NPI: 1437028289
Provider Name (Legal Business Name): COURTNEY RAHE ECKERT AGACNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 PRAIRIE RD
MINNEAPOLIS KS
67467-8533
US

IV. Provider business mailing address

1302 PRAIRIE RD
MINNEAPOLIS KS
67467-8533
US

V. Phone/Fax

Practice location:
  • Phone: 785-527-1023
  • Fax:
Mailing address:
  • Phone: 785-527-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number53-84288-072
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number53-84288-072
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: