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NPI Code Detail

MEDICARE: KATELYN CORDERMAN

MEDICARE: KATELYN CORDERMAN
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
1225100000XPhysical Therapist05012564AIN

General Provider Information

NPI Number : 1750922514
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN CORDERMAN
Provider Business Mailing Address
First Line : 123 SADDLE RIDGE CT
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-9159
Country : US
Telephone Number : 785-787-0686
Fax Number :
Provider Business Practice Location Address
First Line : 1010 W WASHINGTON CENTER RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-4155
Country : US
Telephone Number : 260-203-1582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2019
Last Update Date : 02/05/2026

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Directions to “ KATELYN CORDERMAN ” Practice Location

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