Provider Demographics
NPI:1942895321
Name:CLEVELAND, JAMES CORY (FNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CORY
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 W HANCOCK STREET
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061
Mailing Address - Country:US
Mailing Address - Phone:478-445-5004
Mailing Address - Fax:
Practice Address - Street 1:4355 BROWNS BRIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-4554
Practice Address - Country:US
Practice Address - Phone:770-771-0550
Practice Address - Fax:770-771-5051
Is Sole Proprietor?:No
Enumeration Date:2021-03-07
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN223262163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse