MEDICARE: KARLA CORIA FNP-C

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	363L00000X	Nurse Practitioner	114125	NE

General Provider Information

NPI Number	:	1265173017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA CORIA FNP-C

Provider Business Mailing Address
First Line	:	2652 18TH AVE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-2608
Country	:	US
Telephone Number	:	402-919-4802
Fax Number	:

Provider Business Practice Location Address
First Line	:	4508 38TH ST STE 260
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-1636
Country	:	US
Telephone Number	:	402-564-0205
Fax Number	:	402-564-2607

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

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	06/02/2022

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Directions to “ KARLA CORIA FNP-C” Practice Location

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