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General NPI Number Information
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NPI Number | 1043167505
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Entity Type | Individual
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Provider Name | COURTNEY DUNLAP CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 615 N MICHIGAN ST
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City | SOUTH BEND
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State | IN
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Zip | 46601-1033
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Country | US
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Telephone | 574-647-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 17914 JUNIPER RD
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City | ARGOS
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State | IN
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Zip | 46501-9232
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Country | US
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Telephone | 574-780-8354
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28267328C
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License Number State | IN
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