Provider Demographics
NPI:1710606280
Name:NEWKIRK, COURTNEY YOUNG
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:YOUNG
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11204 EVANS TRL APT 101
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-3905
Mailing Address - Country:US
Mailing Address - Phone:240-758-5567
Mailing Address - Fax:
Practice Address - Street 1:1200 DELEWARE AVE SW
Practice Address - Street 2:#726
Practice Address - City:DISTRICT OF COLUMBIA
Practice Address - State:DC
Practice Address - Zip Code:20024
Practice Address - Country:US
Practice Address - Phone:202-288-1729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant