Provider Demographics
NPI:1689233264
Name:DICKENS, COURTNEY E (MSN, APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:E
Last Name:DICKENS
Suffix:
Gender:F
Credentials:MSN, APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 PLANTATION WAY
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-7406
Mailing Address - Country:US
Mailing Address - Phone:615-405-2676
Mailing Address - Fax:
Practice Address - Street 1:405 STEAM PLANT RD STE 200
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3024
Practice Address - Country:US
Practice Address - Phone:615-442-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000025509363LF0000X
TN25509363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily