Healthcare Provider Details

I. General information

NPI: 1275658841
Provider Name (Legal Business Name): TERESA ANN CORRIGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 DIVISADERO ST
SAN FRANCISCO CA
94115-3011
US

IV. Provider business mailing address

1635 DIVISADERO ST STE 625 BOX 1821
SAN FRANCISCO CA
94143-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number260768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: