Provider Demographics
NPI:1336586445
Name:BARRETT, COURTNEY ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:BARRETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ELIZABETH
Other - Last Name:GROSHONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6355 WALKER LN STE 313
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3258
Mailing Address - Country:US
Mailing Address - Phone:703-313-9111
Mailing Address - Fax:703-313-4945
Practice Address - Street 1:6355 WALKER LN STE 313
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3258
Practice Address - Country:US
Practice Address - Phone:703-313-9111
Practice Address - Fax:703-313-4945
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17026-NP363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0117770Medicaid
OHH436530Medicare PIN