Provider Demographics
NPI:1417479965
Name:KORSZOLOSKI, KATRINA JO (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:JO
Last Name:KORSZOLOSKI
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 1:200 JENNY CV
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-6188
Mailing Address - Country:US
Mailing Address - Phone:901-849-1406
Mailing Address - Fax:
Practice Address - Street 1:317 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-1205
Practice Address - Country:US
Practice Address - Phone:731-221-1804
Practice Address - Fax:731-221-1880
Is Sole Proprietor?:No
Enumeration Date:2017-07-16
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily