MEDICARE: MAUREEN MARIE COURTNEY NP

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
1	363LF0000X	Family Nurse Practitioner	225168	TX

General Provider Information

NPI Number	:	1669479200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN MARIE COURTNEY NP

Provider Business Mailing Address
First Line	:	3308 SUNSET OAKS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5945
Country	:	US
Telephone Number	:	817-845-6318
Fax Number	:	817-469-9090

Provider Business Practice Location Address
First Line	:	3308 SUNSET OAKS ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-5945
Country	:	US
Telephone Number	:	817-845-6318
Fax Number	:	817-469-9090

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/30/2013

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