Provider Demographics
NPI:1841752052
Name:STAGNER, COURTNEE CRISWELL (CRNP)
Entity Type:Individual
Prefix:MS
First Name:COURTNEE
Middle Name:CRISWELL
Last Name:STAGNER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:COURTNEE
Other - Middle Name:
Other - Last Name:CRISWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1515 S UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-2958
Mailing Address - Country:US
Mailing Address - Phone:251-343-9600
Mailing Address - Fax:251-380-7308
Practice Address - Street 1:1515 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2958
Practice Address - Country:US
Practice Address - Phone:251-343-9600
Practice Address - Fax:251-380-7308
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-140693163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL7714OtherRX NUMBER