Provider Demographics
NPI:1013347608
Name:GARVIN, COURTNEY LYN (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:COURTNEY
Middle Name:LYN
Last Name:GARVIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 REFUGEE RD STE 100-A
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9861
Mailing Address - Country:US
Mailing Address - Phone:614-754-5500
Mailing Address - Fax:
Practice Address - Street 1:1025 REFUGEE RD STE 100-A
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9861
Practice Address - Country:US
Practice Address - Phone:614-754-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003936363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant