Provider Demographics
NPI:1235466624
Name:WERNER, COURTNEY SHEA (PNP)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:SHEA
Last Name:WERNER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5110 LANDOVER HILLS LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4920
Mailing Address - Country:US
Mailing Address - Phone:817-504-9807
Mailing Address - Fax:
Practice Address - Street 1:344 SW WILSHIRE BLVD STE I
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-5350
Practice Address - Country:US
Practice Address - Phone:817-442-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX675651363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics