Provider Demographics
NPI:1013013762
Name:PESCI, CORIN ALYSIA (FNP)
Entity Type:Individual
Prefix:
First Name:CORIN
Middle Name:ALYSIA
Last Name:PESCI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CORIN
Other - Middle Name:ALYSIA
Other - Last Name:SHENUSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:508 FULTON ST
Mailing Address - Street 2:DURHAM VA MEDICAL CENTER
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3875
Mailing Address - Country:US
Mailing Address - Phone:919-416-8070
Mailing Address - Fax:919-286-6873
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:DURHAM VA MEDICAL CENTER
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-416-8070
Practice Address - Fax:919-286-6873
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006017363LF0000X
CT003449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily