Provider Demographics
NPI:1730729435
Name:HOLMAN, COURTNEY ELISE (CRNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELISE
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:801 PRINCETON AVE SW STE 707
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 PRINCETON AVE SW STE 707
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1309
Practice Address - Country:US
Practice Address - Phone:251-214-1412
Practice Address - Fax:205-780-7775
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-157853363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL303780Medicaid
AL1-157853OtherCRNP LICENSE