Provider Demographics
NPI:1013584770
Name:COURSEY, ADRIENNE ELISE (DO)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:ELISE
Last Name:COURSEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:ADRIENNE
Other - Middle Name:ELISE
Other - Last Name:DEMAREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:845 COACHMAN WAY
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-7196
Mailing Address - Country:US
Mailing Address - Phone:503-867-4928
Mailing Address - Fax:
Practice Address - Street 1:WOMACK ARMY MEDICAL CENTER 2817 REILLY ROAD
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-8246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2023-00335208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program