Provider Demographics
NPI:1659156297
Name:PLATT, KORTNEY BLAIR (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:KORTNEY
Middle Name:BLAIR
Last Name:PLATT
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 TULANE DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-5961
Mailing Address - Country:US
Mailing Address - Phone:936-404-4602
Mailing Address - Fax:936-262-6504
Practice Address - Street 1:2001 TULANE DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-5961
Practice Address - Country:US
Practice Address - Phone:936-404-4602
Practice Address - Fax:936-262-6504
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF08231246363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily