Provider Demographics
NPI:1750191136
Name:MUTTI, COURTNEY (APRN)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MUTTI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2531
Mailing Address - Country:US
Mailing Address - Phone:850-250-1492
Mailing Address - Fax:850-851-0500
Practice Address - Street 1:825 JENKS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2531
Practice Address - Country:US
Practice Address - Phone:850-250-1492
Practice Address - Fax:850-851-0500
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036978363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health