MEDICARE: MS. CORRIE NUNES

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1386197077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CORRIE NUNES

Provider Business Mailing Address
First Line	:	7224 S RECOVERY RD
Second Line	:
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231-8901
Country	:	US
Telephone Number	:	209-809-9612
Fax Number	:

Provider Business Practice Location Address
First Line	:	7224 S RECOVERY RD
Second Line	:
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231-8901
Country	:	US
Telephone Number	:	209-809-9612
Fax Number	:

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

Provider Enumeration Date	:	07/28/2016
Last Update Date	:	04/02/2024

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