MS. COURTNEY ANN KELLER (NPI# 1336307495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336307495 |
| Entity Type | Individual |
| Full Name | MS. COURTNEY ANN KELLER |
| Other Name | COURTNEY ANN KONDOS/MERCK |
| Credential | PMHNP |
| Practice Address |
9165 W Thunderbird Rd Suite 201 Peoria AZ 85381-4847 |
| Practice Telephone | 6238768420 |
| Practice Fax Number | 6232852626 |
| Mailing Telephone | 6238768420 |
| Mailing Fax Number | 6232852626 |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP7558 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN173592 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0807X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Adolescent |
46 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
46 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BCBS ND | PENDING | 01 |
| ND | 054517 | 05 | |
| AZ | 979757 | 05 | |
| ND | TRICARE | PENDING | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093015851 | Courtney Novey Keller | Physical Therapist | 5308 Richland Dr, Raleigh, NC 27612-3580 | 2010-10-27 |
| 1215457288 | Courtney Nicole Keller | Nurse Practitioner | 1213 N Main St, Beaver Dam, KY 42320-8955 | 2017-06-21 |
| 1962448613 | Courtney A Keller | Physician Assistant | 303 S Main St, Bluffton, IN 46714-2503 | 2006-06-21 |
| Street Address |
9165 W THUNDERBIRD RD SUITE 201 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821632126 | Mental Health Azforvets LLC | Nurse Practitioner | 20469 N 95th Dr, Peoria, AZ 85382-5133 | 2019-10-30 |
| 1881258416 | Tammy E. Hostetler | Nurse Practitioner | 14100 N 83rd Ave Ste 100, Peoria, AZ 85381-4621 | 2019-04-29 |
| 1811483480 | Kimberly Ann Cochran | Nurse Practitioner | 8194 W Deer Valley Rd Ste 106-516, Peoria, AZ 85382 | 2018-07-07 |
| 1992233977 | Jennifer Christine Alexander | Nurse Practitioner | 4215 N Prospect Rd, Peoria, IL 61616-7754 | 2017-06-02 |
| 1801322755 | Juan Gabriel Gomez | Nurse Practitioner | 8203 W Oraibi Dr, Apartment 1142, Peoria, AZ 85382-4680 | 2017-05-11 |
| 1538498738 | Ronnie Abush Brown-woodhull | Nurse Practitioner | Partners In Recovery - West Valley Clinic, 14100 W 83rd Avenue Ste 100, Peoria, AZ 85381 | 2009-12-17 |
| 1730251034 | Lisa D'alessandro-betancourt | Nurse Practitioner | 11361 N 99th Ave Ste 200, Peoria, AZ 85345-5470 | 2006-11-14 |
| 1932713435 | Lori Sue Trilikis | Nurse Practitioner | 7317 N Willow Lake Ct, Peoria, IL 61614-8227 | 2020-09-02 |
| 1821614520 | Shawna Steffes | Nurse Practitioner | 11361 N 99th Ave, Peoria, AZ 85345-5470 | 2020-06-18 |
| 1205458429 | Mosunmoluwa Sokoya | Nurse Practitioner | 9165 W Thunderbird Rd Ste 201, Peoria, AZ 85381-4847 | 2020-05-11 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.