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General NPI Number Information
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NPI Number | 1760147599
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Entity Type | Individual
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Provider Name | COURTNEY HOVESTADT PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/06/2021
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 409 OLIN WAY STE 1200
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City | DENVER
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State | NC
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Zip | 28037-9250
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Country | US
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Telephone | 704-801-7320
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Fax |
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Provider Business Mailing Address
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Address Line | 109 W SHEPHERD RIDGE LN APT 207
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City | MOORESVILLE
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State | NC
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Zip | 28117-7158
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-15148
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License Number State | NC
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