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General NPI Number Information
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NPI Number | 1851250948
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Entity Type | Individual
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Provider Name | KEIANA CORPREW FNP
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Gender | Female
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 250 LOVERS LN
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City | WASHINGTON
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State | NC
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Zip | 27889-3436
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Country | US
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Telephone | 252-975-1636
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 BLACK JACK SIMPSON RD
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City | GREENVILLE
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State | NC
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Zip | 27858-7728
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Country | US
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Telephone | 703-593-6279
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F12250605
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License Number State | NC
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