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General NPI Number Information
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NPI Number | 1558796680
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Entity Type | Individual
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Provider Name | CASEY COURCY
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Gender | Female
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 04/10/2015
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Provider Practice Location Address
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Address Line | 902 CLINT MOORE RD SUITE 227
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City | BOCA RATON
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State | FL
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Zip | 33487-2800
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Country | US
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Telephone | 887-345-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 339 TUSKA RESERVE CV
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City | CASSELBERRY
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State | FL
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Zip | 32707-4133
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9278548
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License Number State | FL
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