Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 215961 | AR |
N | 363LA2100X | Nurse Practitioner - Acute Care | 215961 | AR |
NPI | 1033785175 |
---|---|
Provider Name | Courtney Moody Scarbrough |
First Address | North Little Rock, AR 72117-2922 |
Second Address | North Little Rock, AR 72117-2922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2021 |
Last Update Date | 30/05/2021 |