Provider Demographics
NPI:1982596409
Name:MOBLEY, COURTNEY TA'LEA
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:TA'LEA
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-4005
Mailing Address - Country:US
Mailing Address - Phone:269-986-4395
Mailing Address - Fax:
Practice Address - Street 1:190 E MICHIGAN AVE
Practice Address - Street 2:CLINIC HEALTH DEPT
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017
Practice Address - Country:US
Practice Address - Phone:269-986-4395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker