Healthcare Provider Details

I. General information

NPI: 1235238353
Provider Name (Legal Business Name): COURTNEY HESTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 BOULEVARD NE SUITE 500
ATLANTA GA
30312-1200
US

IV. Provider business mailing address

315 BOULEVARD NE SUITE 500
ATLANTA GA
30312-1200
US

V. Phone/Fax

Practice location:
  • Phone: 404-523-1313
  • Fax:
Mailing address:
  • Phone: 404-523-1313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number004689
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number004689
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: