Provider Demographics
NPI:1265701452
Name:CORONA, WILLIAM (CRNA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:CORONA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5105 85TH AVE W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-1862
Mailing Address - Country:US
Mailing Address - Phone:512-680-4652
Mailing Address - Fax:
Practice Address - Street 1:5105 85TH AVE W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-1862
Practice Address - Country:US
Practice Address - Phone:512-680-4652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87905367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX651529OtherRN LICENSE NUMBER
87905OtherNBCRNA NUMBER