Provider Demographics
NPI:1720377336
Name:MALDONADO, CORINNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4068 E PECOS RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-2529
Mailing Address - Country:US
Mailing Address - Phone:480-279-7315
Mailing Address - Fax:480-279-7307
Practice Address - Street 1:4068 E PECOS RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-2529
Practice Address - Country:US
Practice Address - Phone:480-279-7315
Practice Address - Fax:480-279-7307
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN000099155163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse