Elizabeth Anne Coursey, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN255063 Issued in GA

Practice address

10700 Medlock Bridge Rd Ste 102
Duluth, GA 30097-8455

Phone

(678) 691-5351

Fax

(770) 685-1241

NPI assigned

Jun 23, 2021

Last updated

Apr 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Anne Henderson Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1578132437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE RD STE 102",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978455",
            "telephone_number": "678-910-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE RD STE 102",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978455",
            "telephone_number": "678-691-5351",
            "fax_number": "770-685-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURSEY",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN255063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HENDERSON",
            "middle_name": "ANNE",
            "credential": "CPNP-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cota Medical Management (Clinica de la Mama)
• Carmen Idalys Cotto, O.D.
• Mackenzie W Couch, MS,BCBA
• Bakaramoko Coulibaly, RPH
• Counseling Center at Duluth LLC
• Courtland Health Care Services
• Courtland Hospice Inc
• Michelle Angie Covalt, MD
• Karyanna K Cox
• Nigeria Kysmyu Cox

• Pediatric Nurse Practitioner in Duluth, GA
• Providers in Duluth, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.