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NPI Code Detail

MEDICARE: SANDY JOSEPHINE CORTEZ

MEDICARE:   SANDY JOSEPHINE CORTEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianNC

General Provider Information

NPI Number : 1215714720
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDY JOSEPHINE CORTEZ
Provider Business Mailing Address
First Line : 7603 VAUGHAN CHAPEL RD
Second Line :
City : ELM CITY
State : NC
Zip : 27822-8096
Country : US
Telephone Number : 252-467-7931
Fax Number :
Provider Business Practice Location Address
First Line : 115 W NASHVILLE DR
Second Line :
City : NASHVILLE
State : NC
Zip : 27856-1284
Country : US
Telephone Number : 919-375-0475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2023
Last Update Date : 09/11/2023

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Directions to “ SANDY JOSEPHINE CORTEZ ” Practice Location

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