Provider Demographics
NPI:1386841765
Name:CORRIGAN, TERESA ANN (DCNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:DCNP, FNP-BC
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:JOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DCNP, FNP-BC
Mailing Address - Street 1:1101 ERIE BLVD E STE 201
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1144
Mailing Address - Country:US
Mailing Address - Phone:315-915-3280
Mailing Address - Fax:315-204-1595
Practice Address - Street 1:1101 ERIE BLVD E STE 201
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1144
Practice Address - Country:US
Practice Address - Phone:315-915-3280
Practice Address - Fax:315-204-1595
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5136363LF0000X, 363LF0000X
NY338074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ865934Medicaid
NY07214226Medicaid