MEDICARE: MRS. CHRISTINE ANN COURSEY RN

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	163W00000X	Registered Nurse	R083171	MD

General Provider Information

NPI Number	:	1770469918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE ANN COURSEY RN

Provider Business Mailing Address
First Line	:	1378 OLD WATER OAK POINT RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-2300
Country	:	US
Telephone Number	:	410-437-0896
Fax Number	:	410-437-0896

Provider Business Practice Location Address
First Line	:	1378 OLD WATER OAK POINT RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-2300
Country	:	US
Telephone Number	:	410-437-0896
Fax Number	:

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

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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