Individual
MRS. KOURTNEY ELIZABETH AUGUSTYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
535 BARNHILL DR STE 200, INDIANAPOLIS, IN 46202-5116
(317) 278-7418
(317) 278-7418
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003248A
IN
363A00000X
Physician Assistant
PA10348
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
357488105
—
TX
05
—
357488106
—
TX
01
—
8JH997
BCBS
TX
Enumeration date
10/16/2015
Last updated
12/04/2021
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