Provider Demographics
NPI:1285459115
Name:MARTIN, COURTNEY (DNP)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E ONEIL DR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5573
Mailing Address - Country:US
Mailing Address - Phone:515-451-1905
Mailing Address - Fax:
Practice Address - Street 1:133 E ONEIL DR
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5573
Practice Address - Country:US
Practice Address - Phone:515-451-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG181903363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health