Healthcare Provider Details

I. General information

NPI: 1518883131
Provider Name (Legal Business Name): KORTNEY CORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N SENATE AVE
INDIANAPOLIS IN
46202-5306
US

IV. Provider business mailing address

12217 BECKLEY RD
CUMBERLAND IN
46229-3205
US

V. Phone/Fax

Practice location:
  • Phone: 317-989-6831
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28221091A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: