Provider Demographics
NPI:1548312978
Name:COURSON, BARBARA J (ARNP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:COURSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 E VOORHEES
Mailing Address - Street 2:M/S 790
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61834-0480
Mailing Address - Country:US
Mailing Address - Phone:217-709-2386
Mailing Address - Fax:217-709-2344
Practice Address - Street 1:1301 2ND AVE SW
Practice Address - Street 2:STE 290
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3120
Practice Address - Country:US
Practice Address - Phone:727-674-9990
Practice Address - Fax:727-674-9994
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2916742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q65806Medicare UPIN
U7111ZMedicare ID - Type Unspecified