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Courtney Renee King

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

PECOS Enrollment

This provider is enrolled in PECOS as COURTNEY KING.

Based on the most recent information from CMS, provider Courtney Renee King is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 8 days ago.

Profile Details

Provider ID
1053673319
Provider Type
Individual
Full Name
King, Courtney Renee
Credential
APRN (AANP)

Gender
Female
Sole Proprietor
No
Enumeration Date
6/13/2012
Last Updated
6/22/2021

Contact Information

Practice Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Mailing Location

4500 San Pablo Rd S, Jacksonville, FL 32224-1865

(904) 953-2000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9266552 Florida
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN9266552 Florida
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9266552 Florida

Courtney Renee King

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Hemminger, Lois

Finch, Danielle

Proto-Conroy, Kimberly

Reynolds, Gina

Cuthbert, Kristin

Molloy, Sean

Clark, Brooke L