Individual
COURTNEY HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 WONDER WORLD DR, SAN MARCOS, TX 78666-7533
(512) 753-3571
Mailing address
7301 BURNET RD, SUITE 102-192, AUSTIN, TX 78757-2250
(512) 784-8499
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
608039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85917U
BLUE SHIELD
TX
Enumeration date
04/06/2006
Last updated
07/08/2007
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