Provider Demographics
NPI:1851643720
Name:BRIGGS, COURTNEY (LPN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 GUMWOOD LN
Mailing Address - Street 2:
Mailing Address - City:KUNKLETOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18058-8056
Mailing Address - Country:US
Mailing Address - Phone:570-301-7649
Mailing Address - Fax:
Practice Address - Street 1:724 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1108
Practice Address - Country:US
Practice Address - Phone:610-691-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN274135164W00000X
SC45027164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse