Provider Demographics
NPI:1477098481
Name:HELM, COURTNEY ALEXANDRA (AGNP-C)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ALEXANDRA
Last Name:HELM
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 MANHATTAN BEACH BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5324
Mailing Address - Country:US
Mailing Address - Phone:513-460-7006
Mailing Address - Fax:
Practice Address - Street 1:219 MANHATTAN BEACH BLVD STE 3
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5324
Practice Address - Country:US
Practice Address - Phone:513-460-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017935363L00000X
NC255836363LG0600X, 363LP2300X
AZ226375363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC255836OtherNC MEDICAL LICENSE