Healthcare Provider Details

I. General information

NPI: 1487135232
Provider Name (Legal Business Name): COURTNEY LEE FLANDERS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 ROCKSIDE WOODS BLVD N STE 425
INDEPENDENCE OH
44131-2340
US

IV. Provider business mailing address

1260 WESTFIELD DR
MAUMEE OH
43537-2730
US

V. Phone/Fax

Practice location:
  • Phone: 216-643-2780
  • Fax: 216-524-0111
Mailing address:
  • Phone: 419-388-5195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number023458
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: