Courtney Rae Fabick

Individual provider Active NPI Home Health Registered Nurse · Cottage Grove, WI

NPI 1356993489 · NPPES record last updated Jul 9, 2019

Key facts

NPI
1356993489
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
248831 (WI)
Practice address
5003 Creek Haven Rd
Cottage Grove, WI 53527-9750
Phone
(608) 322-6320
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
248831WIMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 248831 WI Yes

Addresses

Primary practice location

5003 Creek Haven Rd
Cottage Grove, WI 53527-9750

Mailing address

5003 Creek Haven Rd
Cottage Grove, WI 53527-9750

Other providers in Cottage Grove, WI

All providers in Cottage Grove, WI · Home Health Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.