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General NPI Number Information
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NPI Number | 1912534231
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Entity Type | Individual
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Provider Name | ANDREA CORCORAN APRN
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Gender | Female
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Dates
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Enumeration Date | 03/25/2020
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 3109 NW 107TH DR
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City | SUNRISE
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State | FL
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Zip | 33351-6865
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Country | US
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Telephone | 754-246-7292
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Fax |
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Provider Business Mailing Address
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Address Line | 461 MILL SPRINGS LN
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City | PLANTATION
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State | FL
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Zip | 33325-3517
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Country | US
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Telephone | 754-246-7292
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 11006753
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11006753
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1912534231
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License Number State | FL
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