# MRS. COURTNEY LEE BENNETT WILKE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1023321882
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 12767 | GA | Yes |
| 363A00000X | Physician Assistant | PA9105489 | FL | — |

## Other

- **Enumeration date:** 07/22/2010
- **Last updated:** 03/03/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003175470B | — | GA |
| 01 | — | 12767 | GEORGIA COMPOSITE MEDICAL BOARD | GA |