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General NPI Number Information
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NPI Number | 1245162486
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Entity Type | Organization
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Legal Business Name | CORTNEY ICE AESTHETICS & WELLNESS LLC
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 285 MARS HILL RD
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-4308
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Country | US
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Telephone | 404-387-6882
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Fax |
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Provider Business Mailing Address
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Address Line | 285 MARS HILL RD
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-4308
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Country | US
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Telephone | 404-387-6882
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CORTNEY ICE
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Credential | RN
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Telephone | 404-387-6882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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