Provider Demographics
NPI:1508545781
Name:PARKIN, COURTNEY CATHERINE RUTH (ACCNS, ACNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:CATHERINE RUTH
Last Name:PARKIN
Suffix:
Gender:F
Credentials:ACCNS, ACNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12126 DARNLEY RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6613
Mailing Address - Country:US
Mailing Address - Phone:170-398-9712
Mailing Address - Fax:
Practice Address - Street 1:3007 TILDEN ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3008
Practice Address - Country:US
Practice Address - Phone:703-989-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNP1012177363LA2100X
DCCNS1012177364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care