Provider Demographics
NPI:1871250092
Name:CROOK, COURTNEY TAYLOR (RN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:TAYLOR
Last Name:CROOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22526 GUADILAMAR DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-1513
Mailing Address - Country:US
Mailing Address - Phone:661-993-2824
Mailing Address - Fax:
Practice Address - Street 1:22526 GUADILAMAR DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-1513
Practice Address - Country:US
Practice Address - Phone:661-993-2824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95177466163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse