Healthcare Provider Details

I. General information

NPI: 1598612525
Provider Name (Legal Business Name): COURTNEY CLARK DAVIS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 BROOKFORD BLVD
HICKORY NC
28602-9180
US

IV. Provider business mailing address

810 FAIRGROVE CHURCH RD
HICKORY NC
28602-9617
US

V. Phone/Fax

Practice location:
  • Phone: 828-330-2103
  • Fax:
Mailing address:
  • Phone: 828-326-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5024999
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: