Provider Demographics
NPI:1558617431
Name:DEHOFF, COURTNEY (CRNP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:DEHOFF
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 CAHABA RIVER PARC
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3260
Mailing Address - Country:US
Mailing Address - Phone:615-478-5283
Mailing Address - Fax:
Practice Address - Street 1:860 MONTCLAIR RD STE 955
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1951
Practice Address - Country:US
Practice Address - Phone:205-332-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-127583163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse