Provider Demographics
NPI:1649994500
Name:DAVIS, COURTNEY LENORA (MSN, APRN,PMHNP-BC,)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:LENORA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSN, APRN,PMHNP-BC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 LASKIN RD STE 201G
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-5263
Mailing Address - Country:US
Mailing Address - Phone:757-780-8153
Mailing Address - Fax:
Practice Address - Street 1:1206 LASKIN RD STE 201G
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-5263
Practice Address - Country:US
Practice Address - Phone:757-780-8153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001267208163WP0808X
VA0024193930363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health