Provider Demographics
NPI:1649393638
Name:WHITSON, COURTNEY ANNE (RN, MSN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ANNE
Last Name:WHITSON
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 LAGUNA ST
Mailing Address - Street 2:APT 204
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-2289
Mailing Address - Country:US
Mailing Address - Phone:530-848-0507
Mailing Address - Fax:
Practice Address - Street 1:533 PARNASSUS AVE # U585
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2208
Practice Address - Country:US
Practice Address - Phone:415-476-2423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16775363LP0200X
CA2577364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics