Individual
COURTNEY RAE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
12097
NC
231H00000X
Audiologist
4061
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q54201A
MEDICARE
NC
05
—
SAN137
—
SC
Enumeration date
07/12/2016
Last updated
10/10/2022
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