Provider Demographics
NPI:1669951711
Name:NANTZ, CORINNE MARIE (RN, AGNP-C)
Entity type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:MARIE
Last Name:NANTZ
Suffix:
Gender:F
Credentials:RN, AGNP-C
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:MARIE
Other - Last Name:ARUNDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, AGNP-C
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1617 N MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-9021
Practice Address - Country:US
Practice Address - Phone:919-577-9952
Practice Address - Fax:919-577-9946
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010811363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology