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General NPI Number Information
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NPI Number | 1275543134
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Entity Type | Organization
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Legal Business Name | MARIA CRISTINA ATIENZA PSC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 110 ROY KIDD AVE
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City | CORBIN
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State | KY
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Zip | 40701-1302
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Country | US
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Telephone | 606-528-7400
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Fax | 606-528-7449
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Provider Business Mailing Address
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Address Line | PO BOX 545
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City | CORBIN
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State | KY
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Zip | 40702-0545
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Country | US
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Telephone | 606-528-7400
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Fax | 606-528-7449
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Authorized Official
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Title or Position | OWNER
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Name | MARIA C. ATIENZA
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Credential | MD
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Telephone | 606-528-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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