Healthcare Provider Details

I. General information

NPI: 1942832472
Provider Name (Legal Business Name): COURTNEY KILLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY FRENCH KILLIN APRN

II. Dates (important events)

Enumeration Date: 02/12/2020
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 TOWNE BLVD
MIDDLETOWN OH
45005-5506
US

IV. Provider business mailing address

2620 ELM HILL PIKE
NASHVILLE TN
37214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 513-282-3010
  • Fax:
Mailing address:
  • Phone: 615-425-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.026291
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: