Provider Demographics
NPI:1861454985
Name:CORRIGAN, MICHELE A (PA)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NEONATOLOGY SERVICES - ELLIOT HOSPITAL
Mailing Address - Street 2:ONE ELLIOT WAY
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103
Mailing Address - Country:US
Mailing Address - Phone:603-663-2692
Mailing Address - Fax:603-663-3982
Practice Address - Street 1:NEONATOLOGY SERVICES - ELLIOT HOSPITAL
Practice Address - Street 2:ONE ELLIOT WAY
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-663-2692
Practice Address - Fax:603-663-3982
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0292P363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30331307Medicaid
NH30331307Medicaid
NHAP2157Medicare PIN