Individual
COURTNEY T UMPHRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1298 W FINNIE FLAT RD, CAMP VERDE, AZ 86322-5958
(928) 639-5555
Mailing address
5013 S LOUISE AVE # 30538, SIOUX FALLS, SD 57108-2268
(847) 942-0727
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10002869A
IN
363A00000X
Physician Assistant
Primary
10156
AZ
363A00000X
Physician Assistant
PA213392
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300032838
—
IN
Enumeration date
11/21/2019
Last updated
03/18/2024
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