Individual
COURTNEY ATKINS VILLASUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11 FALCON CREST LN, CLYDE, NC 28721-6620
(828) 565-0560
Mailing address
PO BOX 1921, CLYDE, NC 28721-1921
(828) 818-8808
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-15185
NC
363AM0700X
Medical Physician Assistant
Primary
3571
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4228PA
—
SC
Enumeration date
08/09/2019
Last updated
03/25/2025
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