Provider Demographics
NPI:1255015574
Name:NEAL, COURTNEY LYN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LYN
Last Name:NEAL
Suffix:
Gender:F
Credentials:MSN, APRN, 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:PO BOX 271669
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1669
Mailing Address - Country:US
Mailing Address - Phone:928-684-4383
Mailing Address - Fax:928-684-2434
Practice Address - Street 1:523 ROSE LN
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-1448
Practice Address - Country:US
Practice Address - Phone:928-668-1833
Practice Address - Fax:928-684-2434
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ226393363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily