Provider Demographics
NPI:1225558976
Name:CLEMENT, COURTNEY R (DNP, FNP-BC, APRN)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:R
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:DNP, FNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 NORMANDY ST
Mailing Address - Street 2:
Mailing Address - City:NINE MILE POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70094-3078
Mailing Address - Country:US
Mailing Address - Phone:504-512-1802
Mailing Address - Fax:
Practice Address - Street 1:1111 MEDICAL CENTER BLVD STE 350
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3186
Practice Address - Country:US
Practice Address - Phone:504-349-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily