Healthcare Provider Details

I. General information

NPI: 1982563987
Provider Name (Legal Business Name): COURTNEY DANIEL PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E SOUTHERN AVE STE C3
TEMPE AZ
85282-7609
US

IV. Provider business mailing address

2942 N 24TH ST, STE 115 PMB 181521
PHOENIX AZ
85016
US

V. Phone/Fax

Practice location:
  • Phone: 520-772-4868
  • Fax: 520-363-6101
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number289772
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: