Provider Demographics
NPI:1194481465
Name:COURTNEY, JANICE KAY (RDH)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:KAY
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:JANICE
Other - Middle Name:KAY
Other - Last Name:ARNEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:705 E JASPER DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-8944
Mailing Address - Country:US
Mailing Address - Phone:254-288-3436
Mailing Address - Fax:
Practice Address - Street 1:BLDG 39033 SUPPORT AVENUE
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-287-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17162124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist