Healthcare Provider Details

I. General information

NPI: 1376316299
Provider Name (Legal Business Name): COURTNEY BRYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1554 W BEEBE CAPPS EXPY
SEARCY AR
72143-5169
US

IV. Provider business mailing address

1554 W BEEBE CAPPS EXPY
SEARCY AR
72143-5169
US

V. Phone/Fax

Practice location:
  • Phone: 501-781-2230
  • Fax:
Mailing address:
  • Phone: 501-781-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number28723-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: