Provider Demographics
NPI:1962928978
Name:ATWOOD, KOURTNEY (APRN)
Entity type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HELPER
Mailing Address - State:UT
Mailing Address - Zip Code:84526-1535
Mailing Address - Country:US
Mailing Address - Phone:435-472-7000
Mailing Address - Fax:
Practice Address - Street 1:125 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HELPER
Practice Address - State:UT
Practice Address - Zip Code:84526-1535
Practice Address - Country:US
Practice Address - Phone:435-472-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6239108-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily