Provider Demographics
NPI:1639282684
Name:CUPPY, CORINNE ANNE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:ANNE
Last Name:CUPPY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CORINNE
Other - Middle Name:ANNE
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3700 BARRETT DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7173
Mailing Address - Country:US
Mailing Address - Phone:919-782-1806
Mailing Address - Fax:919-234-0357
Practice Address - Street 1:17001 SEARSTONE DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8385
Practice Address - Country:US
Practice Address - Phone:919-234-0352
Practice Address - Fax:919-234-0357
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15722363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant