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NPI Code Detail

MEDICARE: MS. COURTNEY ALLEN CRNA

MEDICARE: MS. COURTNEY ALLEN CRNA
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
1163W00000XRegistered Nurse0001250279VA
2367500000XCertified Registered Nurse Anesthetist0024190281VA

General Provider Information

NPI Number : 1609557990
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. COURTNEY ALLEN CRNA
Provider Business Mailing Address
First Line : 7922 SHORE DR APT 317
Second Line :
City : NORFOLK
State : VA
Zip : 23518-2407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1881 UNIVERSITY DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23453-8083
Country : US
Telephone Number : 757-368-4171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2023
Last Update Date : 06/14/2024

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