Courtney Leigh Petroff, RN BSN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2012008949 Issued in MO

Practice address

915 N Grand Blvd
Saint Louis, MO 63106-1621

Phone

(314) 652-4100

NPI assigned

Jun 5, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Leigh Phillips Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1881007912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7472 ARLINGTON DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631172220",
            "telephone_number": "314-401-5257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROFF",
        "first_name": "COURTNEY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2012008949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "PHILLIPS",
            "middle_name": "LEIGH",
            "credential": "RN BSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela M Petri
• Michelle Renee Petrich, MD
• Jane K Petrie, MSW, LCSW
• Alexis Rose Petrilla, LBA, BCBA
• Tricia Petrillo
• Emily Ann Petroline, PHARM D
• Giulia Eva Maria Petrone, MD
• Jessica S Petrone, MD
• Emiko Petrosky, M.D.
• Tatyana Petrosova, MD

• Registered Nurse in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.