NPI Code Detail JSON Logo

1033097787 NPI number — COURTNEY E CLARK FNP-BC, ARNP

NPI Number: 1033097787
Health Care Provider/Practitioner: COURTNEY E CLARK FNP-BC, ARNP

Information about “1033097787” NPI (COURTNEY E CLARK FNP-BC, ARNP) exists in 1033097787 in HTML format HTML  |  1033097787 in plain Text format TXT  |  1033097787 in PDF (Portable Document Format) PDF  |  1033097787 in an XML format XML  formats.

NPI Number : 1033097787 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033097787",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CLARK",
    "FirstName": "COURTNEY",
    "MiddleName": "E",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP-BC, ARNP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 674721",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75267-4721",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "515-643-2519",
    "MailingAddressFaxNumber": "515-461-9783",
    "FirstLinePracticeLocationAddress": "2006 N 4TH ST STE 200",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANOLA",
    "PracticeLocationAddressStateName": "IA",
    "PracticeLocationAddressPostalCode": "50125-4500",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "515-461-9784",
    "PracticeLocationAddressFaxNumber": "515-461-9783",
    "EnumerationDate": "08/21/2025",
    "LastUpdateDate": "11/23/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "A186336",
        "LicenseNumberStateCode": "IA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.