Provider Demographics
NPI:1104391689
Name:WILLIAMS, COURTNEY BROOKE (MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:BROOKE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PASOFINA DR
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-5769
Mailing Address - Country:US
Mailing Address - Phone:304-841-1798
Mailing Address - Fax:
Practice Address - Street 1:712 E 70TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4811
Practice Address - Country:US
Practice Address - Phone:912-352-8974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245144363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily