Provider Demographics
NPI:1548955818
Name:PRICE, COURTNEY LEIGH (RN, BSN, MED)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LEIGH
Last Name:PRICE
Suffix:
Gender:F
Credentials:RN, BSN, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 INDEPENDENCE AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1444
Mailing Address - Country:US
Mailing Address - Phone:615-300-8457
Mailing Address - Fax:
Practice Address - Street 1:447 TENNESSEE AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5433
Practice Address - Country:US
Practice Address - Phone:202-996-5435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty