Provider Demographics
NPI:1558655894
Name:BUCHHOLZ, CORTNEY RUTH (RN)
Entity type:Individual
Prefix:MISS
First Name:CORTNEY
Middle Name:RUTH
Last Name:BUCHHOLZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2452 HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:TWO HARBORS
Mailing Address - State:MN
Mailing Address - Zip Code:55616-3000
Mailing Address - Country:US
Mailing Address - Phone:218-310-2562
Mailing Address - Fax:
Practice Address - Street 1:810 E 4TH ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2147
Practice Address - Country:US
Practice Address - Phone:218-728-4491
Practice Address - Fax:218-302-8698
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11563363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health