Provider Demographics
NPI:1669892196
Name:COURTNEY SPEED
Entity type:Organization
Organization Name:COURTNEY SPEED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PRACTICAL NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:SPEED
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:216-970-4870
Mailing Address - Street 1:19101 SHAWNEE AVE.
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119
Mailing Address - Country:US
Mailing Address - Phone:216-970-4870
Mailing Address - Fax:
Practice Address - Street 1:19101 SHAWNEE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-2715
Practice Address - Country:US
Practice Address - Phone:216-970-4870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH150548251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care