Provider Demographics
NPI:1013769983
Name:STIRN, COURTNEY ALLISON
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ALLISON
Last Name:STIRN
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 1:12417 BRANNER WAY APT 201
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-2807
Mailing Address - Country:US
Mailing Address - Phone:727-457-8861
Mailing Address - Fax:
Practice Address - Street 1:10510 JEFFERSON AVE STE D
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3102
Practice Address - Country:US
Practice Address - Phone:757-594-4720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program