Provider Demographics
NPI:1962078998
Name:VANNI, COURTNEY DIANNE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:DIANNE
Last Name:VANNI
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 HOSPITAL DR STE 310
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2387
Mailing Address - Country:US
Mailing Address - Phone:318-212-7430
Mailing Address - Fax:318-212-7435
Practice Address - Street 1:2400 HOSPITAL DR STE 310
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2387
Practice Address - Country:US
Practice Address - Phone:318-212-7430
Practice Address - Fax:318-212-7435
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA220158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily