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Individual

MS. ELAINE COURTNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
529 SOUTH JACKSON STREET, LOUISVILLE, KY 40202
(502) 562-4363
(502) 562-4373
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 562-4363
(502) 562-4373

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA08659
TX
363A00000X
Physician Assistant
Primary
TC519
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
331715801
TX
05
7100437090
KY
Enumeration date
10/14/2013
Last updated
01/26/2017
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