Healthcare Provider Details

I. General information

NPI: 1780501817
Provider Name (Legal Business Name): COURTNEY ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 PINE ST APT 902
SAN FRANCISCO CA
94108-3060
US

IV. Provider business mailing address

899 PINE ST APT 902
SAN FRANCISCO CA
94108-3060
US

V. Phone/Fax

Practice location:
  • Phone: 404-610-5679
  • Fax:
Mailing address:
  • Phone: 404-610-5679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: