Provider Demographics
NPI:1215224605
Name:HUNSICKER, COURTNEY ANN (CNP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ANN
Last Name:HUNSICKER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:ANN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:36000 EUCLID AVE
Mailing Address - Street 2:MSO
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094
Mailing Address - Country:US
Mailing Address - Phone:440-953-6082
Mailing Address - Fax:440-953-6101
Practice Address - Street 1:36100 EUCLID AVE STE 400
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4429
Practice Address - Country:US
Practice Address - Phone:440-602-6735
Practice Address - Fax:440-946-3392
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12633-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH039313OtherMEDICARE
OH0056115Medicaid