Provider Demographics
NPI:1538776109
Name:BROWN, COURTNEY CROCKER (NP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:CROCKER
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:MARIE
Other - Last Name:CROCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6565 WEST LOOP S STE 800
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3505
Mailing Address - Country:US
Mailing Address - Phone:713-661-4383
Mailing Address - Fax:
Practice Address - Street 1:6565 WEST LOOP S STE 800
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3505
Practice Address - Country:US
Practice Address - Phone:713-661-4383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX916259163W00000X
TX1030664363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse