Kourtney Christin Henrickson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

314450-031 Issued in WI

Practice address

1946 30TH St
Two Rivers, WI 54241-2022

Phone

(920) 905-3307

NPI assigned

Apr 9, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kourtney Christin Thompson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1508122011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 30TH ST",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542412022",
            "telephone_number": "920-905-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1946 30TH ST",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542412022",
            "telephone_number": "920-905-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRICKSON",
        "first_name": "KOURTNEY",
        "middle_name": "CHRISTIN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "314450-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOURTNEY",
            "last_name": "THOMPSON",
            "middle_name": "CHRISTIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marissa Lee Harfert, MA, BCBA
• Scott W Harris, C.R.N.A.
• Michael John Heidt, LAT
• Emily Heimerl
• Catherine Henrickson
• Julia D Hester-Diaz, MD
• Priscilla Carolina Hidalgo, MD
• Nathan R Hoftiezer, D.D.S
• Kristen J Horkheimer, CRNA
• Noah Horkheimer, CRNA

• All providers in Two Rivers, WI
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.