Provider Demographics
NPI:1811442726
Name:POLLARD, COURTNEY BROOKE (RN)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:BROOKE
Last Name:POLLARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 DOONEY DR
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5111
Mailing Address - Country:US
Mailing Address - Phone:678-773-0187
Mailing Address - Fax:
Practice Address - Street 1:3655 CANTON RD STE 201
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-7614
Practice Address - Country:US
Practice Address - Phone:678-903-5197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-20
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN216580163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse