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NPI Code Detail

MEDICARE: MRS. COURTNEY B MANATT APN

MEDICARE: MRS. COURTNEY B MANATT APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerA01569 ANPAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760562078
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COURTNEY B MANATT APN
Provider Business Mailing Address
First Line : PO BOX 497
Second Line :
City : AUGUSTA
State : AR
Zip : 72006-0497
Country : US
Telephone Number : 870-347-2534
Fax Number :
Provider Business Practice Location Address
First Line : 615 N MAIN ST
Second Line :
City : BRINKLEY
State : AR
Zip : 72021-2507
Country : US
Telephone Number : 870-734-1150
Fax Number : 870-734-1179
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 01/21/2026

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Directions to “ MRS. COURTNEY B MANATT APN” Practice Location

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