Provider Demographics
NPI:1205442035
Name:COURTNEY, RODNEY KENT (CEP)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:KENT
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:CEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:RIMROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86335-0041
Mailing Address - Country:US
Mailing Address - Phone:928-890-4586
Mailing Address - Fax:
Practice Address - Street 1:4930 N. TENDERFOOT TRAIL
Practice Address - Street 2:
Practice Address - City:RIMROCK
Practice Address - State:AZ
Practice Address - Zip Code:86335
Practice Address - Country:US
Practice Address - Phone:928-890-4586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32142146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic