Provider Demographics
NPI:1922705433
Name:SPILLERS, CORINNE MALONEY (RN, CNS)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:MALONEY
Last Name:SPILLERS
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:ELLEN
Other - Last Name:MALONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1370 GRANT LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-2562
Mailing Address - Country:US
Mailing Address - Phone:530-391-5995
Mailing Address - Fax:
Practice Address - Street 1:4301 X ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2214
Practice Address - Country:US
Practice Address - Phone:916-703-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA779537163WN0002X
CA4826364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care