1962157081 NPI number — CORTNEY YVONNE LUCAS WHITE CPC, CADS

Table of content: CORTNEY YVONNE LUCAS WHITE CPC, CADS (NPI 1962157081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962157081 NPI number — CORTNEY YVONNE LUCAS WHITE CPC, CADS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUCAS WHITE
Provider First Name:
CORTNEY
Provider Middle Name:
YVONNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPC, CADS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962157081
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3343 PEACHTREE RD NE STE 145
Provider Second Line Business Mailing Address:
(ATLANTA FINANCIAL CENTER)-1454
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-337-3789
Provider Business Mailing Address Fax Number:
888-847-4491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 WESTWOOD PKWY APT 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30168-6876
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-905-7271
Provider Business Practice Location Address Fax Number:
888-847-4497
Provider Enumeration Date:
02/16/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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