Courtney Beth Legendre
Nurse Practitioner
545 Valley View Drive
Moline
, Illinois 61265-6138
Courtney Beth Legendre
Nurse Practitioner
545 Valley View Drive
Moline
, Illinois 61265-6138
(309) 762-7351
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Courtney Beth Legendre
- 545 Valley View Drive
- Moline, IL
- Zip : 61265-6138
- Fax : (309) 762-7351
- Phone : (309) 762-5560
Second Address
- Courtney Beth Legendre
- 545 Valley View Drive
- Moline, IL
- Zip : 61265-6138
- Fax : (309) 762-7351
- Phone : (309) 762-5560
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209005686 | IL |
National Provider Identifier
| NPI | 1003956871 |
|---|---|
| Provider Name | Courtney Beth Legendre |
| First Address | Moline, IL 61265-6138 |
| Second Address | Moline, IL 61265-6138 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/02/2007 |
| Last Update Date | 02/02/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 209005686 | ILLINOIS LICENSE (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.