Provider Demographics
NPI:1346453487
Name:CAHILL, COURTNEY A (PA-C)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:CAHILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14239 W. BELL ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SURPIRSE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374
Mailing Address - Country:US
Mailing Address - Phone:623-544-7755
Mailing Address - Fax:623-544-8665
Practice Address - Street 1:14239 W. BELL ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374
Practice Address - Country:US
Practice Address - Phone:623-544-7755
Practice Address - Fax:623-544-8665
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2553363AM0700X
AZ3495363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical