Provider Demographics
NPI:1033204813
Name:CORW, MACLYN (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:MACLYN
Middle Name:
Last Name:CORW
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 N FOOTE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-4554
Mailing Address - Country:US
Mailing Address - Phone:719-630-8111
Mailing Address - Fax:719-630-1620
Practice Address - Street 1:525 N FOOTE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-4554
Practice Address - Country:US
Practice Address - Phone:719-630-8111
Practice Address - Fax:719-630-1620
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO161812163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical