Provider Demographics
NPI:1386254068
Name:FRADY, COURTNEY ELISABETH (NP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ELISABETH
Last Name:FRADY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:COURTNEY
Other - Middle Name:ELISABETH
Other - Last Name:FRADY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 744786
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-4786
Mailing Address - Country:US
Mailing Address - Phone:704-834-2450
Mailing Address - Fax:704-671-5331
Practice Address - Street 1:2525 COURT DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2140
Practice Address - Country:US
Practice Address - Phone:704-834-2000
Practice Address - Fax:704-834-2500
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013390363L00000X, 363LF0000X
OHAPRN.CNP.0031893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner