Provider Demographics
NPI:1578948451
Name:HOSSLE, CORINA (CPM, LM)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:
Last Name:HOSSLE
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 TIMBERS HILL RD
Mailing Address - Street 2:APT 06-F
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-3960
Mailing Address - Country:US
Mailing Address - Phone:954-675-5436
Mailing Address - Fax:
Practice Address - Street 1:2006 TIMBERS HILL RD
Practice Address - Street 2:APT 06-F
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-3960
Practice Address - Country:US
Practice Address - Phone:954-675-5436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0129-00108176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife