Individual
COURTNEY OTTS MANTOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
801 PRINCETON AVE SW STE 707, BIRMINGHAM, AL 35211
(205) 780-4330
Mailing address
801 PRINCETON AVE SW STE 707, BIRMINGHAM, AL 35211-1395
(205) 780-4330
(205) 780-7775
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-150536
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-150536
ALABAMA RN LICENSE
AL
05
—
243254
—
AL
Enumeration date
10/03/2018
Last updated
05/13/2024
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