Healthcare Provider Details

I. General information

NPI: 1073143814
Provider Name (Legal Business Name): CORIE ANN BAUGH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORIE ANN ROSETTI

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 MEGA WAY
FURLONG PA
18925-1610
US

IV. Provider business mailing address

94 MEGA WAY
FURLONG PA
18925-1610
US

V. Phone/Fax

Practice location:
  • Phone: 267-573-8149
  • Fax:
Mailing address:
  • Phone: 267-573-8149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP021345
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: