Provider Demographics
NPI:1871186056
Name:KASPER, COURTNEY (APRN-BC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:KASPER
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:EARNEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-BC
Mailing Address - Street 1:2200 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3315
Mailing Address - Country:US
Mailing Address - Phone:407-740-5127
Mailing Address - Fax:
Practice Address - Street 1:2200 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3315
Practice Address - Country:US
Practice Address - Phone:407-740-5127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11006631363L00000X
FLAPRN11006631363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner