Provider Demographics
NPI:1083190599
Name:COURTNEY, MACKENZIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E 19TH AVE STE 5000
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1254
Mailing Address - Country:US
Mailing Address - Phone:303-839-7100
Mailing Address - Fax:303-839-7249
Practice Address - Street 1:1601 E 19TH AVE STE 5000
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1254
Practice Address - Country:US
Practice Address - Phone:303-839-7100
Practice Address - Fax:303-839-7249
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994001-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily