Provider Demographics
NPI:1770162406
Name:HOLCOMB, COURTNEY (FNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11140 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:FRANKSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75763-4824
Mailing Address - Country:US
Mailing Address - Phone:936-674-9372
Mailing Address - Fax:
Practice Address - Street 1:11140 HICKORY LN
Practice Address - Street 2:
Practice Address - City:FRANKSTON
Practice Address - State:TX
Practice Address - Zip Code:75763-4824
Practice Address - Country:US
Practice Address - Phone:936-674-9372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily