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NPI Code Detail

MEDICARE: MS. TRACI MARIE CORDA R.N.

MEDICARE: MS. TRACI MARIE CORDA R.N.
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
1163WC0400XCase Management Registered Nurse352570CA

General Provider Information

NPI Number : 1780731125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRACI MARIE CORDA R.N.
Provider Business Mailing Address
First Line : 11893 PROSPECT HILL DR
Second Line :
City : GOLD RIVER
State : CA
Zip : 95670-8250
Country : US
Telephone Number : 530-886-3633
Fax Number :
Provider Business Practice Location Address
First Line : 11484 B AVE
Second Line :
City : AUBURN
State : CA
Zip : 95603-2603
Country : US
Telephone Number : 530-886-3633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 07/08/2007

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