Provider Demographics
NPI:1083952204
Name:PIERRE, COURTNEY L
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:L
Last Name:PIERRE
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:PO BOX 15849
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2549
Mailing Address - Country:US
Mailing Address - Phone:912-303-3552
Mailing Address - Fax:912-303-3506
Practice Address - Street 1:5353 REYNOLDS ST
Practice Address - Street 2:STE 300
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6015
Practice Address - Country:US
Practice Address - Phone:912-355-9738
Practice Address - Fax:912-355-5643
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN164191363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology