Provider Demographics
NPI:1396367157
Name:HUGGANS, COURTNEY RAE
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:RAE
Last Name:HUGGANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:RAE
Other - Last Name:SAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 S SANTA FE AVE, SUITE 300
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4189
Mailing Address - Country:US
Mailing Address - Phone:785-452-6911
Mailing Address - Fax:785-452-7807
Practice Address - Street 1:501 S SANTA FE AVE, SUITE 300
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4189
Practice Address - Country:US
Practice Address - Phone:785-452-6911
Practice Address - Fax:785-452-7807
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-02434363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant