Provider Demographics
NPI:1619316262
Name:BROPHY, COURTNEY NYCHELLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:NYCHELLE
Last Name:BROPHY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 HARTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-2723
Mailing Address - Country:US
Mailing Address - Phone:330-801-2823
Mailing Address - Fax:
Practice Address - Street 1:863 HARTFORD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2723
Practice Address - Country:US
Practice Address - Phone:330-801-2823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.119513-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse