MEDICARE: MRS. COURTNEY HARPER PA-C

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	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	12359811-1206	UT

General Provider Information

NPI Number	:	1982227641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY HARPER PA-C

Provider Business Mailing Address
First Line	:	522 E 100 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1905
Country	:	US
Telephone Number	:	801-485-5055
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 E 100 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1905
Country	:	US
Telephone Number	:	801-485-5055
Fax Number	:

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

Provider Enumeration Date	:	05/28/2020
Last Update Date	:	03/10/2026

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Directions to “ MRS. COURTNEY HARPER PA-C” Practice Location

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