| NPI | 1831440759 |
|---|---|
| Former Name | COURTNEY AVERETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 879673) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R879673) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2018-10-05 |