MEDICARE: CORINNE ALYSSA AUSTIN 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	AP61537381	WA

General Provider Information

NPI Number	:	1508610445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINNE ALYSSA AUSTIN FNP

Provider Business Mailing Address
First Line	:	9918 N BLUFF VIEW DR
Second Line	:
City	:	HAUSER
State	:	ID
Zip	:	83854-6585
Country	:	US
Telephone Number	:	434-282-4105
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 N SULLIVAN RD STE 20
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99037-8530
Country	:	US
Telephone Number	:	434-282-4105
Fax Number	:

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

Provider Enumeration Date	:	04/16/2024
Last Update Date	:	12/10/2025

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