Provider Demographics
NPI:1568141117
Name:SHIMP NICHOLS, COURTNEY JO (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JO
Last Name:SHIMP NICHOLS
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:JO
Other - Last Name:SHIMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2744 BENSON SHADY GROVE AVE LOT 1
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:IA
Mailing Address - Zip Code:50648-9410
Mailing Address - Country:US
Mailing Address - Phone:319-429-1711
Mailing Address - Fax:
Practice Address - Street 1:1089 JORDAN CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5830
Practice Address - Country:US
Practice Address - Phone:319-635-6397
Practice Address - Fax:844-687-7646
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA175394207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine