Provider Demographics
NPI:1245715671
Name:MEDVED, COURTNEY (FNP-C)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MEDVED
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 WIND RIVER DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-3183
Mailing Address - Country:US
Mailing Address - Phone:970-227-9924
Mailing Address - Fax:
Practice Address - Street 1:427 WIND RIVER DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-3183
Practice Address - Country:US
Practice Address - Phone:970-227-9924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994119-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily