Healthcare Provider Details

I. General information

NPI: 1922705433
Provider Name (Legal Business Name): CORINNE MALONEY SPILLERS RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORINNE ELLEN MALONEY RN

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 02/15/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 X ST
SACRAMENTO CA
95817-2214
US

IV. Provider business mailing address

1370 GRANT LN
SACRAMENTO CA
95822-2562
US

V. Phone/Fax

Practice location:
  • Phone: 916-703-3050
  • Fax:
Mailing address:
  • Phone: 530-391-5995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number4826
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number779537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: