Provider Demographics
NPI:1841952165
Name:CORREA DUQUE, MAGDALENA PAZ
Entity type:Individual
Prefix:
First Name:MAGDALENA PAZ
Middle Name:
Last Name:CORREA DUQUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVENIDA PUNTA ARENAS 7662
Mailing Address - Street 2:
Mailing Address - City:SANTIAGO
Mailing Address - State:REGION METROPOLITANA
Mailing Address - Zip Code:8260312
Mailing Address - Country:CL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:VICUNA MACKENNA 4860
Practice Address - Street 2:ESCUELA DE ENFERMERIA
Practice Address - City:SANTIAGO
Practice Address - State:REGION METROPOLITANA
Practice Address - Zip Code:8330024
Practice Address - Country:CL
Practice Address - Phone:562-354-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2338626163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse