Provider Demographics
NPI:1932376761
Name:CORTEZ, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CORTEZ
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 1:1717 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1717 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1801
Practice Address - Country:US
Practice Address - Phone:800-822-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-062898367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051590882OtherBCBS
AL051590886OtherBCBS
AL051590893OtherBCBS
AL051590895OtherBCBS
AL102778Medicaid
AL102784Medicaid
AL051590900OtherBCBS
AL102764Medicaid
AL102769Medicaid
AL102779Medicaid
AL102781Medicaid
AL051590887OtherBCBS
AL102777Medicaid
AL102786Medicaid
AL051590907OtherBCBS
AL051590891OtherBCBS
AL102772Medicaid
AL051590901OtherBCBS
AL051590904OtherBCBS
AL102767Medicaid
AL102777Medicaid