Provider Demographics
NPI:1245711639
Name:GELD, COURTNEY LEE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:LEE
Last Name:GELD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:LEE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1555 W NASA BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2640
Mailing Address - Country:US
Mailing Address - Phone:321-733-2201
Mailing Address - Fax:321-733-2202
Practice Address - Street 1:1555 W NASA BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2640
Practice Address - Country:US
Practice Address - Phone:321-733-2201
Practice Address - Fax:321-733-2202
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9401472363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health