Provider Demographics
NPI:1891848768
Name:CORKERY, KAREN ANN (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:CORKERY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5700
Mailing Address - Country:US
Mailing Address - Phone:813-684-2229
Mailing Address - Fax:813-813-0330
Practice Address - Street 1:505 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5700
Practice Address - Country:US
Practice Address - Phone:813-684-2229
Practice Address - Fax:813-813-0330
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9206795363LX0001X
FLAPRN9206795363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308167200Medicaid
FLU1752Medicare PIN