Provider Demographics
NPI:1184977274
Name:PRICE, KOURTNE MESHUN
Entity type:Individual
Prefix:
First Name:KOURTNE
Middle Name:MESHUN
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 CROZIER ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-4251
Mailing Address - Country:US
Mailing Address - Phone:972-768-9533
Mailing Address - Fax:
Practice Address - Street 1:4506 CROZIER ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-4251
Practice Address - Country:US
Practice Address - Phone:972-768-9533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide