Healthcare Provider Details

I. General information

NPI: 1033712716
Provider Name (Legal Business Name): CORA ONEAL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PALMYRA RD FL 3
ALBANY GA
31701-1528
US

IV. Provider business mailing address

5224 75TH ST STE D
LUBBOCK TX
79424-2525
US

V. Phone/Fax

Practice location:
  • Phone: 229-789-6120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3-003028
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07200095
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: