Provider Demographics
NPI:1275017840
Name:HERENDEEN, COURTNEY N (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:N
Last Name:HERENDEEN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:N
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-876-2100
Mailing Address - Fax:614-876-2120
Practice Address - Street 1:5263 NIKE STATION WAY
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7449
Practice Address - Country:US
Practice Address - Phone:614-876-2100
Practice Address - Fax:614-876-2120
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023591363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner