Provider Demographics
NPI:1881935542
Name:HIGHLEYMAN, COURTNEY LAINE (CRNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LAINE
Last Name:HIGHLEYMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LAINE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1255 S CEDAR CREST BLVD STE 3500
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6385
Practice Address - Country:US
Practice Address - Phone:610-969-0100
Practice Address - Fax:610-969-0101
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily