Provider Demographics
NPI:1508582545
Name:MIDDLETON, COURTNEY ALEXANDRIA (NMD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ALEXANDRIA
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 E MORTEN AVE UNIT 231
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4616
Mailing Address - Country:US
Mailing Address - Phone:480-658-8347
Mailing Address - Fax:
Practice Address - Street 1:8759 E BELL RD UNIT G
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1340
Practice Address - Country:US
Practice Address - Phone:602-755-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22-1749175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath