Individual
DR. COURTNEY ELLEN HALISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4565 MARKET BELL WAY, POWELL, TN 37849
(865) 374-3450
(865) 374-1146
Mailing address
4565 MARKET BELL WAY, POWELL, TN 37849
(865) 374-3450
(865) 374-1146
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
29530
NE
207Q00000X
Family Medicine Physician
Primary
64835
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q076530
—
TN
Enumeration date
05/30/2015
Last updated
08/07/2025
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