Email rcvd from: PDMCOGZ@cigna.com  Subject: Enrollment Form || Valley Med Urgent Care PLLC || Lopez, Mayra Alejandra || Ci...  Dear Health Care Professional,  We received your recent request, a copy of which is enclosed.  If you have any questions, please send an email to Intake_PDM@cigna.com and include  Cigna Internal Reference # (W202101201473534).  Provider Name / Group Name         NPI                   TIN                        Effective / Termination Date               Status  Mayra A Lopez                             1265945125     815123542                            1/28/2020                             Contracted  As per the source document the request has been completed.  Sincerely,  Data Management