Provider Demographics
NPI:1740539535
Name:MCGEE, COURTNEY (PA)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:MICHELLE
Other - Last Name:BREAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:319 GREEN ACRES RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1170
Mailing Address - Country:US
Mailing Address - Phone:502-437-6818
Mailing Address - Fax:850-243-0471
Practice Address - Street 1:319 GREEN ACRES RD
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1170
Practice Address - Country:US
Practice Address - Phone:850-243-7681
Practice Address - Fax:850-243-0471
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106693363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical