Provider Demographics
NPI:1831749613
Name:CARLSON, COURTNEY ELIZABETH (DNP, APRN-CNM)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELIZABETH
Last Name:CARLSON
Suffix:
Gender:F
Credentials:DNP, APRN-CNM
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ELIZABETH
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD # MS 2028
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-6200
Mailing Address - Fax:913-945-6036
Practice Address - Street 1:2000 OLATHE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8505
Practice Address - Country:US
Practice Address - Phone:913-588-6200
Practice Address - Fax:913-945-6036
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78975-021367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife