Provider Demographics
NPI:1124544820
Name:RABB, COURTNEY JORDAN (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:JORDAN
Last Name:RABB
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E HIGHLAND MALL BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3731
Mailing Address - Country:US
Mailing Address - Phone:512-807-0640
Mailing Address - Fax:
Practice Address - Street 1:314 E HIGHLAND MALL BLVD STE 305
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3731
Practice Address - Country:US
Practice Address - Phone:512-807-0640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX838879163W00000X
TX1179847363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse