Healthcare Provider Details

I. General information

NPI: 1013899756
Provider Name (Legal Business Name): COURTNEY L SINE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY LIN SINE

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST STE 5254
DAYTON OH
45409-2939
US

IV. Provider business mailing address

5209 SPRINGFIELD URBANA PIKE
URBANA OH
43078-8414
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-4200
  • Fax: 937-208-2678
Mailing address:
  • Phone: 937-405-8618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0039853
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: