Provider Demographics
NPI:1326300864
Name:MILLER, COURTNEY MARIE (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:MARIE
Other - Last Name:GRIMSRUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:1500 PARK CENTRAL DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-6688
Practice Address - Country:US
Practice Address - Phone:720-455-3775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60734961207XX0004X
CODR.0060364207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1326300864Medicaid
WA8966535OtherMEDICARE PIN