Provider Demographics
NPI:1033785175
Name:SCARBROUGH, COURTNEY MOODY (APRN, AGACNP-BC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MOODY
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-227-9080
Mailing Address - Fax:501-227-0410
Practice Address - Street 1:9500 BAPTIST HEALTH DR STE 501
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6319
Practice Address - Country:US
Practice Address - Phone:501-227-9080
Practice Address - Fax:501-227-0410
Is Sole Proprietor?:No
Enumeration Date:2021-05-30
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR215961363L00000X, 363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology