Provider Demographics
NPI:1942829676
Name:LEMMON, COURTNEY ELIZABETH (FNP-BC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:LEMMON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7188 WELLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63143-3502
Mailing Address - Country:US
Mailing Address - Phone:314-650-2433
Mailing Address - Fax:
Practice Address - Street 1:1115 OLIVETTE EXECUTIVE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63132-3259
Practice Address - Country:US
Practice Address - Phone:314-282-3990
Practice Address - Fax:314-282-9524
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020025196363LF0000X
MO2014005173163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse