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NPI Code Detail

MEDICARE: CORIN SERENE FORKUS

MEDICARE: CORIN SERENE FORKUS
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1720943814
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORIN SERENE FORKUS
Provider Business Mailing Address
First Line : 108 MAPLE AVE
Second Line :
City : ATKINSON
State : NH
Zip : 03811-2245
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 159 N BROADWAY
Second Line :
City : SALEM
State : NH
Zip : 03079-2136
Country : US
Telephone Number : 603-893-4119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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Directions to “ CORIN SERENE FORKUS ” Practice Location

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