Provider Demographics
NPI:1871470351
Name:ROBERTS, COURTNEY ANNE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ANNE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 R ST APT 1709
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-4012
Mailing Address - Country:US
Mailing Address - Phone:402-480-2481
Mailing Address - Fax:
Practice Address - Street 1:5000 R ST APT 1709
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-4012
Practice Address - Country:US
Practice Address - Phone:402-480-2481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant