Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | RN255158 | GA |
N | 207V00000X | Obstetrician & Gynecologist | UNKNOWN | GA |
NPI | 1063073088 |
---|---|
Provider Name | Mrs. Rachel Lewis Cofield |
First Address | Cordele, GA 31010-5610 |
Second Address | Athens, GA 30606-2153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2019 |
Last Update Date | 14/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NA | NA (01) |