Individual
COURTNEY WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11513 N MAIN ST, JACKSONVILLE, FL 32218-4002
(904) 751-6200
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9108237
FL
363A00000X
Physician Assistant
PAT9108237
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KO410
MEDICARE
FL
Enumeration date
09/18/2014
Last updated
05/10/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us