MEDICARE: MRS. COURTNEY ELLEN CLARDY FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	17656	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255778759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY ELLEN CLARDY FNP

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:	615-322-5048

Provider Business Practice Location Address
First Line	:	1612 N MAIN ST STE A
Second Line	:
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-2392
Country	:	US
Telephone Number	:	931-680-2310
Fax Number	:	931-685-4158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2013
Last Update Date	:	07/23/2025

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