Individual
COURTNEY JOY KENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
734 ELM ST SW, ALBANY, OR 97321-1934
(541) 812-5111
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
201508511NP-PP
OR
Other
Enumeration date
11/08/2015
Last updated
02/19/2024
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