Provider Demographics
NPI:1184958571
Name:HASTINGS, COURTNEY ANNE (MSN, FNP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ANNE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:RIVERSIDE MEDICAL GROUP
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-594-4006
Mailing Address - Fax:
Practice Address - Street 1:12100 WARWICK BLVD STE 201
Practice Address - Street 2:PENINSULA CANCER INSTITUTE
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-2365
Practice Address - Country:US
Practice Address - Phone:757-534-5555
Practice Address - Fax:757-534-5567
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024173214363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily