# DR. COURTNEY ELLEN HALISTA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1417337965
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 29530 | NE | — |
| 207Q00000X | Family Medicine Physician | 64835 | TN | Yes |

## Other

- **Enumeration date:** 05/30/2015
- **Last updated:** 08/07/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | Q076530 | — | TN |