Provider Demographics
NPI:1912026675
Name:HOEPPNER, CORRINE CARLA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CORRINE
Middle Name:CARLA
Last Name:HOEPPNER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2356 YALE AVE E
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3386
Mailing Address - Country:US
Mailing Address - Phone:206-324-4029
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:MS B 6553
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-3176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005915363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4300847Medicaid
ID806601800Medicaid
WANP3156WMedicaid
ID806601800Medicaid
WAP88252Medicare UPIN