Dudley, Courtney

Dudley, Courtney is an individual health care provider with primary practice located at 6475 Camden Ave Ste 107 , San Jose CA 95120-2847. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Obstetric, High-Risk, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Dudley, Courtney can be contacted via phone (713) 992-6677.

Contact Information

Primary practice address
6475 Camden Ave Ste 107 San Jose CA 95120-2847
Phone: (713) 992-6677
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Obstetric, High-Risk 163WX0002X 752771 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 20814 California

Profile Details

NPI number 1871861427
LBN Legal business name Dudley, Courtney
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2011
Last updated May 20th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871861427 NPPES
California MEDICAID 1871861427

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