Provider Demographics
NPI:1831316264
Name:BOLICK, COURTNEY NICOLE (ARNP)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:NICOLE
Last Name:BOLICK
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 1:7119 SAN JOSE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-3423
Mailing Address - Country:US
Mailing Address - Phone:352-871-7650
Mailing Address - Fax:904-585-8116
Practice Address - Street 1:2820 NE 214TH ST
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1268
Practice Address - Country:US
Practice Address - Phone:855-444-7258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG176361363LP0808X
MTAPRN-186226363LP0808X
FL9206412363LP0808X
KS53-80743-112363LP0808X
VT101.0134931363LP0808X
MO2020012458363LP0808X
OH0030973363LP0808X
DEL8-0010880363LP0808X
FLARNP 9206412363LF0000X
CA17236363LP0808X
NV823873363LP0808X
NY406720363LP0808X
TN30143363LP0808X
NDR48558363LP0808X
DCNP200005709363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily