Provider Demographics
NPI:1861190126
Name:GREGORY, COURTNEY MORRELL (CNP)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:MORRELL
Last Name:GREGORY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:993 JOHNSON FERRY RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1620
Mailing Address - Country:US
Mailing Address - Phone:404-780-7860
Mailing Address - Fax:404-851-8673
Practice Address - Street 1:993 JOHNSON FERRY RD STE 120
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-780-7860
Practice Address - Fax:404-851-8673
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33454363LG0600X
GAGAA-NP002134363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ081556Medicaid