Provider Demographics
NPI:1356105225
Name:KUJANSUU, COURTNEY MARIE (MSN, RN)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:KUJANSUU
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 ELKHORN DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-9489
Mailing Address - Country:US
Mailing Address - Phone:309-370-2630
Mailing Address - Fax:
Practice Address - Street 1:4150 ELKHORN DR
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-9489
Practice Address - Country:US
Practice Address - Phone:309-370-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007018968364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal