Provider Demographics
NPI:1518503135
Name:CAHILL, COREY A (CRNP)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:A
Last Name:CAHILL
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:COREY
Other - Middle Name:A
Other - Last Name:CAHILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:55 ROWE DR STE B
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-7366
Mailing Address - Country:US
Mailing Address - Phone:256-571-8450
Mailing Address - Fax:256-840-4584
Practice Address - Street 1:55 ROWE DR STE B
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-7366
Practice Address - Country:US
Practice Address - Phone:256-571-8450
Practice Address - Fax:256-840-4584
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-147137163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty