Provider Demographics
NPI:1609481985
Name:COURTNEY, CARLY (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27323 SHADY HILLS LANDING LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3227
Mailing Address - Country:US
Mailing Address - Phone:432-556-6875
Mailing Address - Fax:
Practice Address - Street 1:9595 SIX PINES DRIVE #4250
Practice Address - Street 2:SUITE 105
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:346-745-1498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-13
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1011817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily