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General NPI Number Information
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NPI Number | 1093020752
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Entity Type | Individual
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Provider Name | JAMMIE DAWN CORONA ACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 2024 BLACK JACK LOOP UNIT A
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City | CHEYENNE
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State | WY
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Zip | 82001-7272
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Country | US
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Telephone | 256-200-1192
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Fax |
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Provider Business Mailing Address
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Address Line | 33 ROSE LOOP
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City | FORT LEAVENWORTH
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State | KS
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Zip | 66027-1147
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Country | US
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Telephone | 256-200-1192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 28495.1059
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 28495.1059
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License Number State | WY
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