black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

CORNELL MICA ERVIN

PRODUCER NON-RESIDENT

License Number:
PRN496153
Status:
First Licensure:
09/21/2024
Cancel Date:
None

Mailing:
DULUTH, GA 30096
Phone:
+1 (770) 605-9555
Fax:
+1 (770) 605-9555
Email:
cornellervintaylor@gmail.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/21/2024

Agency

None.

Employer

Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
11/19/2025 HMD45749
ANTHEM HEALTH PLANS OF MAINE INC.
09/21/2024 LHD70566 12/12/2024
ANTHEM INSURANCE COMPANIES INC
09/21/2024 LHF125537 12/12/2024
ARCADIAN HEALTH PLAN INC
06/13/2025 HMF112421 08/28/2025
ARCADIAN HEALTH PLAN INC
02/27/2026 HMF112421
EMPHESYS INSURANCE COMPANY
02/11/2026 LHF410560
EMPIRE HEALTHCHOICE HMO, INC.
09/21/2024 HMF285382 12/12/2024
GOLDEN RULE INSURANCE COMPANY
01/21/2026 LHF918 04/02/2026
SIERRA HEALTH AND LIFE INSURANCE COMPANY INC.
05/19/2025 LHF58195 09/04/2025

Authority

Description Issue Date Termination Date Status
HEALTH 09/21/2024 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
20793221

Other Addresses

Address Type
DULUTH, GA 30096
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 04/16/2026 10:10:28 PM