Provider Demographics
NPI:1952875544
Name:POWELL, COURTNEY HELMS (NP-C)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:HELMS
Last Name:POWELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-9900
Mailing Address - Fax:704-384-9919
Practice Address - Street 1:1918 RANDOLPH RD STE 580
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1116
Practice Address - Country:US
Practice Address - Phone:704-384-9900
Practice Address - Fax:704-384-9919
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPOWE-Q005YB363LF0000X
NC5012053363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily