Provider Demographics
NPI:1023536232
Name:DOWEN, COURTNEY R (NP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:R
Last Name:DOWEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 ALLENS AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5010
Mailing Address - Country:US
Mailing Address - Phone:401-780-2511
Mailing Address - Fax:401-780-2565
Practice Address - Street 1:100 CURTIS ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-3623
Practice Address - Country:US
Practice Address - Phone:401-444-0540
Practice Address - Fax:401-444-0424
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.007212363L00000X
RIAPRN02842363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner