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NPI Code Detail

MEDICARE: COURTNEY NICOLE ALLEN APRN

MEDICARE: COURTNEY NICOLE ALLEN APRN
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 PractitionerAPRN11000038FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700340130
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY NICOLE ALLEN APRN
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line :
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number :
Provider Business Practice Location Address
First Line : 2824 ENTERPRISE RD
Second Line :
City : ORANGE CITY
State : FL
Zip : 32763-8428
Country : US
Telephone Number : 386-774-7411
Fax Number : 386-774-7412
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2019
Last Update Date : 02/09/2026

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Directions to “ COURTNEY NICOLE ALLEN APRN” Practice Location

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