Provider Demographics
NPI:1225848732
Name:MONROE, COURTNEY NICOLE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:NICOLE
Last Name:MONROE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 S HILTON PARK RD
Mailing Address - Street 2:
Mailing Address - City:FRUITPORT
Mailing Address - State:MI
Mailing Address - Zip Code:49415-8684
Mailing Address - Country:US
Mailing Address - Phone:231-903-9222
Mailing Address - Fax:
Practice Address - Street 1:4705 S HILTON PARK RD
Practice Address - Street 2:
Practice Address - City:FRUITPORT
Practice Address - State:MI
Practice Address - Zip Code:49415-8684
Practice Address - Country:US
Practice Address - Phone:231-903-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy