Provider Demographics
NPI:1316730294
Name:COURSEY, ANSLEY PAYTON
Entity type:Individual
Prefix:
First Name:ANSLEY
Middle Name:PAYTON
Last Name:COURSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 MONTAG CIR NE UNIT 140
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-5529
Mailing Address - Country:US
Mailing Address - Phone:404-583-4427
Mailing Address - Fax:
Practice Address - Street 1:185 MONTAG CIR NE UNIT 140
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-5529
Practice Address - Country:US
Practice Address - Phone:404-583-4427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF04250127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily