Provider Demographics
NPI:1851130603
Name:COURTRIGHT, IRENENA R
Entity type:Individual
Prefix:
First Name:IRENENA
Middle Name:R
Last Name:COURTRIGHT
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 1:4141 PALM AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95842-4215
Mailing Address - Country:US
Mailing Address - Phone:701-721-5092
Mailing Address - Fax:
Practice Address - Street 1:4141 PALM AVE APT 209
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95842-4215
Practice Address - Country:US
Practice Address - Phone:701-721-5092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula