Provider Demographics
NPI:1669850178
Name:HOEPPNER, COURTNEY L (APRN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:L
Last Name:HOEPPNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:BACHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5330 STADIUM TRACE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4528
Mailing Address - Country:US
Mailing Address - Phone:205-968-1518
Mailing Address - Fax:
Practice Address - Street 1:5330 STADIUM TRACE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4528
Practice Address - Country:US
Practice Address - Phone:205-968-1518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009155363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily