Provider Demographics
NPI:1295321305
Name:CORSO, BILLIE JOE (APRN, RN)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:JOE
Last Name:CORSO
Suffix:
Gender:F
Credentials:APRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6902 STATE ROUTE 93 NW
Mailing Address - Street 2:
Mailing Address - City:DUNDEE
Mailing Address - State:OH
Mailing Address - Zip Code:44624-8734
Mailing Address - Country:US
Mailing Address - Phone:330-204-4304
Mailing Address - Fax:
Practice Address - Street 1:6902 STATE ROUTE 93 NW
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:OH
Practice Address - Zip Code:44624-8734
Practice Address - Country:US
Practice Address - Phone:330-204-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0026836363L00000X, 363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health