Provider Demographics
NPI:1457810814
Name:STOKES, CORRINE E (NURSE MIDWIFE)
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:E
Last Name:STOKES
Suffix:
Gender:F
Credentials:NURSE MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3513
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:2300 DUBOIS DR
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3213
Practice Address - Country:US
Practice Address - Phone:574-371-2620
Practice Address - Fax:260-479-2903
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-15
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09000321A367A00000X
IN71008858A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife