Provider Demographics
NPI:1003622143
Name:HARMAN PHILPOTTS, CORRINE
Entity type:Individual
Prefix:MRS
First Name:CORRINE
Middle Name:
Last Name:HARMAN PHILPOTTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 SW 70TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33317-7131
Mailing Address - Country:US
Mailing Address - Phone:408-300-5993
Mailing Address - Fax:
Practice Address - Street 1:2230 SW 70TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33317-7131
Practice Address - Country:US
Practice Address - Phone:408-300-5993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9482541163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse