Provider Demographics
NPI:1487832986
Name:CORRECTIONS CORP. OF AMERICA
Entity Type:Organization
Organization Name:CORRECTIONS CORP. OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KIRST-MILLSPAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RN,C,APN
Authorized Official - Phone:505-466-4174
Mailing Address - Street 1:10 BURTON HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6105
Mailing Address - Country:US
Mailing Address - Phone:505-384-2711
Mailing Address - Fax:505-384-0240
Practice Address - Street 1:209 EAST ALLEN AYERS
Practice Address - Street 2:
Practice Address - City:ESTANCIA
Practice Address - State:NM
Practice Address - Zip Code:87016-0837
Practice Address - Country:US
Practice Address - Phone:505-384-2711
Practice Address - Fax:505-384-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR60905261QP2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health