Provider Demographics
NPI:1487632071
Name:COURTNEY, RENEE K (NP)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:K
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:LYNETTE
Other - Last Name:KOLODZIEJSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44405 WOODWARD AVE
Mailing Address - Street 2:OUTCOMES MANAGEMENT
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5023
Mailing Address - Country:US
Mailing Address - Phone:248-858-3061
Mailing Address - Fax:248-858-6022
Practice Address - Street 1:44405 WOODWARD AVE
Practice Address - Street 2:OUTCOMES MANAGEMENT
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5023
Practice Address - Country:US
Practice Address - Phone:248-858-3061
Practice Address - Fax:248-858-6022
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704212791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner