Provider Demographics
NPI:1659596765
Name:FROST, CORRINE K
Entity Type:Individual
Prefix:MRS
First Name:CORRINE
Middle Name:K
Last Name:FROST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 HWY 281 NE
Mailing Address - Street 2:
Mailing Address - City:CARRINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:58421-8795
Mailing Address - Country:US
Mailing Address - Phone:701-652-1729
Mailing Address - Fax:
Practice Address - Street 1:16 S 8TH ST
Practice Address - Street 2:
Practice Address - City:NEW ROCKFORD
Practice Address - State:ND
Practice Address - Zip Code:58356-1520
Practice Address - Country:US
Practice Address - Phone:701-947-5015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND144235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist