Provider Demographics
NPI:1972914497
Name:COURSON, JESSICA LYNNE (NP-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNNE
Last Name:COURSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
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Mailing Address - Street 1:1111 GLYNCO PARKWAY
Mailing Address - Street 2:BLDG1 STE 10
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525
Mailing Address - Country:US
Mailing Address - Phone:912-264-9111
Mailing Address - Fax:912-262-6909
Practice Address - Street 1:903 WEST WARD STREET
Practice Address - Street 2:SUITE B
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533
Practice Address - Country:US
Practice Address - Phone:912-260-1191
Practice Address - Fax:912-260-1193
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN190877363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily