Provider Demographics
NPI:1477019925
Name:FAIRCHILD, COURTNEY ERIN (PA-C)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ERIN
Last Name:FAIRCHILD
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 1:331 WHEDBEE ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2935
Mailing Address - Country:US
Mailing Address - Phone:501-628-6810
Mailing Address - Fax:
Practice Address - Street 1:204 MCCOLLUM ST STE 106E
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-5151
Practice Address - Country:US
Practice Address - Phone:970-682-3377
Practice Address - Fax:970-682-3340
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical