Basic Information
| Provider Information | |||||||||
| NPI: | 1861957938 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HENSLEY | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | PEPPER | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3005 AMBROSE AVE | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372074709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8446736968 | ||||||||
| FaxNumber: | 8446736968 | ||||||||
| Practice Location | |||||||||
| Address1: | 1714 DAVIE AVE | ||||||||
| Address2: | |||||||||
| City: | STATESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286773522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047680542 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2019 | ||||||||
| LastUpdateDate: | 02/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 204666 | TN | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 25556 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.