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NPI Code Detail

MEDICARE: COURTNEY BETH LEGENDRE FNP

MEDICARE: COURTNEY BETH LEGENDRE FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner209005686IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1209005686OTHERILILLINOIS LICENSE

General Provider Information

NPI Number : 1003956871
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY BETH LEGENDRE FNP
Provider Business Mailing Address
First Line : 500 W RIVER DR
Second Line :
City : DAVENPORT
State : IA
Zip : 52801-1014
Country : US
Telephone Number : 563-336-3000
Fax Number : 563-336-3125
Provider Business Practice Location Address
First Line : 2750 11TH ST
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-5216
Country : US
Telephone Number : 563-336-3000
Fax Number : 563-327-2102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 10/15/2025

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Directions to “ COURTNEY BETH LEGENDRE FNP” Practice Location

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