Provider Demographics
NPI:1013681840
Name:DELLINGER, KORI (AGACNP)
Entity Type:Individual
Prefix:
First Name:KORI
Middle Name:
Last Name:DELLINGER
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 E RICE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-2324
Mailing Address - Country:US
Mailing Address - Phone:505-328-4579
Mailing Address - Fax:
Practice Address - Street 1:1985 E RICE DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2324
Practice Address - Country:US
Practice Address - Phone:505-328-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN212130208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist