Fussell, Courtney A

Fussell, Courtney A is an sole proprietor health care provider with primary practice located at 115 E Gold St Ste 518 , Kings Mountain NC 28086-3431. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Fussell, Courtney A can be contacted via phone (980) 404-0678.

Contact Information

Primary practice address
115 E Gold St Ste 518 Kings Mountain NC 28086-3431
Phone: (980) 404-0678
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 25902 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 5010598 North Carolina

Profile Details

NPI number 1568953099
LBN Legal business name Fussell, Courtney A
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 21st, 2018
Last updated May 17th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568953099 NPPES
North Carolina Other 87-3728031 IRS

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