Provider Demographics
NPI:1346684966
Name:THURMAN, CORETTA LATONYA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CORETTA
Middle Name:LATONYA
Last Name:THURMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24416-1830
Mailing Address - Country:US
Mailing Address - Phone:540-570-2999
Mailing Address - Fax:
Practice Address - Street 1:2009 WARDS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5309
Practice Address - Country:US
Practice Address - Phone:540-570-2999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily