Provider Demographics
NPI:1134200041
Name:CORLETT, KAREN (CPNP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:CORLETT
Suffix:
Gender:F
Credentials:CPNP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:FA. 2. 300A, SEATTLE CHILDREN'S HOSPITAL
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5005
Mailing Address - Country:US
Mailing Address - Phone:206-987-2000
Mailing Address - Fax:866-771-0383
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:FA. 2. 300A, SEATTLE CHILDREN'S HOSPITAL
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98145-5005
Practice Address - Country:US
Practice Address - Phone:206-987-2000
Practice Address - Fax:866-771-0383
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX701304363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00802219OtherRR MEDICARE PTAN
TX2101586-01Medicaid
TXP00802219OtherRR MEDICARE PTAN