Healthcare Provider Details

I. General information

NPI: 1952620098
Provider Name (Legal Business Name): CORINNE FOX REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4163 REED RD
LIVONIA NY
14487-9402
US

IV. Provider business mailing address

4163 REED RD
LIVONIA NY
14487-9402
US

V. Phone/Fax

Practice location:
  • Phone: 585-367-8258
  • Fax:
Mailing address:
  • Phone: 585-367-8258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number533244
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: