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NPI Code Detail

MEDICARE: LAUREN KORNACKER ARNP

MEDICARE: LAUREN KORNACKER ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerARNP9381582FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043753726
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN KORNACKER ARNP
Provider Business Mailing Address
First Line : PO BOX 82969
Second Line :
City : TAMPA
State : FL
Zip : 33682-2969
Country : US
Telephone Number : 813-866-0930
Fax Number :
Provider Business Practice Location Address
First Line : 6216 E SLIGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33617-9105
Country : US
Telephone Number : 813-549-8060
Fax Number : 813-549-7843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2016
Last Update Date : 11/29/2016

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Directions to “ LAUREN KORNACKER ARNP” Practice Location

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