Provider Demographics
NPI:1508935628
Name:CORKERN, GAIL P (NP)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:P
Last Name:CORKERN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1025 PENNOCK PL
Mailing Address - Street 2:SUITE 114
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3257
Mailing Address - Country:US
Mailing Address - Phone:970-495-8800
Mailing Address - Fax:970-495-8820
Practice Address - Street 1:1025 PENNOCK PL
Practice Address - Street 2:SUITE 114
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3257
Practice Address - Country:US
Practice Address - Phone:970-495-8800
Practice Address - Fax:970-495-8820
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2016-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO77829363L00000X
COAPN.0000530-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO449934YQXKMedicare PIN
COC8HBX68Medicare PIN
COP34319Medicare UPIN