Provider Demographics
NPI:1710268537
Name:HARDEN, COURTNEY E (NP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:E
Last Name:HARDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:E
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:204 N HAMILTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2662
Mailing Address - Country:US
Mailing Address - Phone:804-353-1230
Mailing Address - Fax:
Practice Address - Street 1:204 N HAMILTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2662
Practice Address - Country:US
Practice Address - Phone:804-353-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169588363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0017140194OtherPRESCRIPTIVE AUTHORITY LICENSE