Individual provider Active NPI

Courtney Servello, CRNP

  • Family Nurse Practitioner
  • Ebensburg, PA
National Provider Identifier
1659946101
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP023300 Issued in PA
Practice address
167 Zeman Dr
Ebensburg, PA 15931-4103
Phone
(824) 472-9119
NPI assigned
May 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP023300 PA Primary

Addresses

Primary practice location

167 Zeman Dr
Ebensburg, PA 15931-4103

Mailing address

114 Houndstooth Way Apt 200
Hollidaysburg, PA 16648-3253
Phone (814) 935-2919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314000037 PA Order and Referring Only - Nurse Practitioner 1557735610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP023300PAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1659946101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HOUNDSTOOTH WAY APT 200",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166483253",
            "telephone_number": "814-935-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 ZEMAN DR",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314103",
            "telephone_number": "824-472-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVELLO",
        "first_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ebensburg, PA

Sources for this page

Verify at the official NPI Registry.