Provider Type Icon

MRS. COURTNEY ANN PROVINE CRNP NPI 1497153472


NPI Information

NPI: 1497153472
Provider Name: MRS. COURTNEY ANN PROVINE, CRNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: UNIVERSITY OF PENN MEDICAL GROUP

PECOS Registration: Yes

Address:
3400 CIVIC CENTER BLVD
2 SOUTH
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 615-0718
Get Directions

MRS. Courtney Ann Provine, CRNP is an acute care nurse practitioner in Philadelphia, PA with 10 years of experience. MRS. Courtney Ann Provine, CRNP NPI is 1497153472. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3400 CIVIC CENTER BLVD
2 SOUTH
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 615-0718
Fax: (215) 349-8309

The NPI 1497153472 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)

The enumeration date for this NPI number is 12/8/2014 and was last updated on 11/15/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamilySP014616PENNSYLVANIANo
2363LA2100XNurse PractitionerAcute CareSP021617PENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14324295OTHERPENNSYLVANIACIGNA PA
21029886820001MEDICAIDPENNSYLVANIA
330218673OTHERPENNSYLVANIAKEYSTONE FIRST
43120472OTHERPENNSYLVANIAHIGHMARK BLUE SHIELD
55764869OTHERPENNSYLVANIAAETNA
6P01435312OTHERPENNSYLVANIARAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.