Cdg Healthcare Provider, P.C.

LBN: Dr. Coretta D. Gervin Healthcare
Cdg Healthcare Provider, P.C. is an health care organization with primary practice located at 414 N Westover Blvd Ste D1 , Albany GA 31707-2102. The organization recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Home Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Nursing Service Providers / Home Health is the primary health care specialty. Dr. Coretta D. Gervin Healthcare can be contacted via phone (404) 710-6646, or through Keith, Coretta Delia via phone (404) 710-6646.

Contact Information

Primary practice address
414 N Westover Blvd Ste D1 Albany GA 31707-2102
Phone: (404) 710-6646
Fax: (229) 234-1391
Website:
Map and Directions
Authorized official contact:
Name: Keith, Coretta Delia DNP, FNP-BC
Phone: (404) 710-6646

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Home Health 163WH0200X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1467091629
LBN Legal business name Dr. Coretta D. Gervin Healthcare
DBA Doing business as Cdg Healthcare Provider, P.C.
Authorized official Keith, Coretta Delia DNP, FNP-BC
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 4th, 2020
Last updated Aug 10th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467091629 NPPES
Georgia MEDICAID 003239804A
Georgia MEDICAID 003239804B

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