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General NPI Number Information
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NPI Number | 1689481624
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Entity Type | Individual
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Provider Name | CORTNEY LYNN MUDDIMAN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 2011 TATE SPRINGS RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-1111
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Country | US
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Telephone | 434-947-3963
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Fax |
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Provider Business Mailing Address
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Address Line | 1095 BOONSBORO MEADOWS DR
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City | LYNCHBURG
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State | VA
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Zip | 24503-3941
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Country | US
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Telephone | 434-426-9716
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 24192075
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License Number State | VA
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