Provider Demographics
NPI:1588334890
Name:AUSTIN, COURTNEY JAYNE (PA-C)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JAYNE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1286 FLORIDA AVE S STE 1
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2400
Mailing Address - Country:US
Mailing Address - Phone:321-636-7780
Mailing Address - Fax:321-633-3043
Practice Address - Street 1:1286 FLORIDA AVE S STE 1
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2400
Practice Address - Country:US
Practice Address - Phone:321-636-7780
Practice Address - Fax:321-636-1152
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2023-07-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant