Provider Demographics
NPI:1952893554
Name:PAPPS, CORINNA ALYSIA (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:CORINNA
Middle Name:ALYSIA
Last Name:PAPPS
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BUCKLAND PL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4567
Mailing Address - Country:US
Mailing Address - Phone:785-248-4477
Mailing Address - Fax:
Practice Address - Street 1:104 BUCKLAND PL
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4567
Practice Address - Country:US
Practice Address - Phone:785-248-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL47652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer