Provider Demographics
NPI:1073353041
Name:VEGA, COURTNEY (CNM)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:VEGA
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:DORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5290A BRICK CHURCH PIKE
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-9005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 STONECREST BLVD STE 310
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6801
Practice Address - Country:US
Practice Address - Phone:629-206-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife