MEDICARE: MRS. BARBARA CORRAL FNP

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
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0028714	OH

General Provider Information

NPI Number	:	1235705278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BARBARA CORRAL FNP

Provider Business Mailing Address
First Line	:	7056 CULVER BLVD
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4623
Country	:	US
Telephone Number	:	440-622-9613
Fax Number	:

Provider Business Practice Location Address
First Line	:	7056 CULVER BLVD
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4623
Country	:	US
Telephone Number	:	440-622-9613
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	06/01/2021

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Directions to “ MRS. BARBARA CORRAL FNP” Practice Location

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