Provider Demographics
NPI:1184319493
Name:CORA HEALTH SOLUTIONS LLC
Entity type:Organization
Organization Name:CORA HEALTH SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:602-295-4529
Mailing Address - Street 1:4647 N 32ND ST STE B-200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3345
Mailing Address - Country:US
Mailing Address - Phone:602-295-4529
Mailing Address - Fax:
Practice Address - Street 1:4647 N 32ND ST STE B-200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3345
Practice Address - Country:US
Practice Address - Phone:602-295-4529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty