Provider Demographics
NPI:1578707428
Name:BUCHANAN, CORINNE MARGARET (NP)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:MARGARET
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9399 CROWN CREST BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8539
Mailing Address - Country:US
Mailing Address - Phone:303-783-8844
Mailing Address - Fax:303-783-2002
Practice Address - Street 1:9399 CROWN CREST BLVD STE 320
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8539
Practice Address - Country:US
Practice Address - Phone:303-783-8844
Practice Address - Fax:303-783-2002
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18436363LA2100X
COAPN.0993082-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFY503ZMedicare PIN