Healthcare Provider Details

I. General information

NPI: 1003301409
Provider Name (Legal Business Name): COURTNEY JEAN MARIE MAYO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 OUTER DR N
SIOUX CITY IA
51104-1585
US

IV. Provider business mailing address

814 PIERCE ST STE 300
SIOUX CITY IA
51101-1058
US

V. Phone/Fax

Practice location:
  • Phone: 712-239-3300
  • Fax: 712-239-8201
Mailing address:
  • Phone: 712-226-2600
  • Fax: 712-226-2605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA114464
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: