MEDICARE: COURTNEY ARIELLE EVERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)	L-61025	FL

General Provider Information

NPI Number	:	1891654299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY ARIELLE EVERSON

Provider Business Mailing Address
First Line	:	20875 NW 207TH TER
Second Line	:
City	:	HIGH SPRINGS
State	:	FL
Zip	:	32643-6805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20875 NW 207TH TER
Second Line	:
City	:	HIGH SPRINGS
State	:	FL
Zip	:	32643-6805
Country	:	US
Telephone Number	:	352-875-1288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ COURTNEY ARIELLE EVERSON ” Practice Location

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