Provider Demographics
NPI:1255778759
Name:CLARDY, COURTNEY ELLEN (FNP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:ELLEN
Last Name:CLARDY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1612 N MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2391
Mailing Address - Country:US
Mailing Address - Phone:931-685-2022
Mailing Address - Fax:931-685-4158
Practice Address - Street 1:1612 N MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2391
Practice Address - Country:US
Practice Address - Phone:931-685-2022
Practice Address - Fax:931-685-4158
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily