MEDICARE: MRS. COURTNEY NUTT

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	1041C0700X	Clinical Social Worker		GA

General Provider Information

NPI Number	:	1568391209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY NUTT

Provider Business Mailing Address
First Line	:	8825 BAYHILL DR
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30506-8012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4411 SUWANEE DAM RD
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-8701
Country	:	US
Telephone Number	:	770-283-8386
Fax Number	:

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ MRS. COURTNEY NUTT ” Practice Location

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