Provider Demographics
NPI:1922198449
Name:CHERPAK, CORRINE M (ARNP)
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:M
Last Name:CHERPAK
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 1:16610 BLENHEIM DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-6812
Mailing Address - Country:US
Mailing Address - Phone:813-948-8921
Mailing Address - Fax:
Practice Address - Street 1:16610 BLENHEIM DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6812
Practice Address - Country:US
Practice Address - Phone:813-948-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP459992163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE0205AMedicare ID - Type Unspecified