Healthcare Provider Details

I. General information

NPI: 1033132691
Provider Name (Legal Business Name): LINDA KAY CORKADEL APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 CENTRAL PARK DR
STEAMBOAT SPRINGS CO
80487-8816
US

IV. Provider business mailing address

2403 CLUBHOUSE DR
STEAMBOAT SPRINGS CO
80487-9052
US

V. Phone/Fax

Practice location:
  • Phone: 970-871-2363
  • Fax:
Mailing address:
  • Phone: 970-870-9856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberC062704
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: