MEDICARE: SUZAN MORGAN CORCORAN I ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	AP30003710	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659335347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZAN MORGAN CORCORAN I ARNP

Provider Business Mailing Address
First Line	:	5901 N LIDGERWOOD ST
Second Line	:	#126
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-489-5110
Fax Number	:	509-489-2850

Provider Business Practice Location Address
First Line	:	5901 N LIDGERWOOD ST
Second Line	:	#126
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-489-5110
Fax Number	:	509-489-2850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	05/10/2021

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