Provider Demographics
NPI:1124607007
Name:GALY, COURTNEY HELENE (PA-C, RDN)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:HELENE
Last Name:GALY
Suffix:
Gender:F
Credentials:PA-C, RDN
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:HELENE
Other - Last Name:TERRYN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1223 MERCY DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1829
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3570 HENRY ST STE 120
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4576
Practice Address - Country:US
Practice Address - Phone:231-672-7000
Practice Address - Fax:231-728-5041
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133V00000X
MI5601010403363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered