Provider Demographics
NPI:1992399067
Name:PFLUGHOEFT, COURTNEY LAUREN (APNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:LAUREN
Last Name:PFLUGHOEFT
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LAUREN
Other - Last Name:CORNELLA-CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:34700 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4500
Mailing Address - Country:US
Mailing Address - Phone:262-646-4411
Mailing Address - Fax:
Practice Address - Street 1:34700 VALLEY RD
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4500
Practice Address - Country:US
Practice Address - Phone:262-646-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10762-332084P0800X
WI10762363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner