Healthcare Provider Details

I. General information

NPI: 1487974374
Provider Name (Legal Business Name): CORINNE NICOLE DUNCAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 GUERRERO ST
SAN FRANCISCO CA
94110-4324
US

IV. Provider business mailing address

1005A CHURCH ST
SAN FRANCISCO CA
94114-3414
US

V. Phone/Fax

Practice location:
  • Phone: 415-821-0697
  • Fax: 415-821-3568
Mailing address:
  • Phone: 415-889-7433
  • Fax: 707-636-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95001103
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNPF95001103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: