Provider Demographics
NPI:1407807209
Name:DOOLEY, CORINNE (NP)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 S STERLING ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4044
Mailing Address - Country:US
Mailing Address - Phone:828-580-6753
Mailing Address - Fax:828-580-6755
Practice Address - Street 1:2201 S STERLING ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4044
Practice Address - Country:US
Practice Address - Phone:828-580-6753
Practice Address - Fax:828-580-6755
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007775363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1407807209Medicaid
MATX1176Medicare PIN
MAP38945Medicare UPIN
MANP3424Medicare PIN