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Individual
MRS. MARY CORLEY
Active
Individual
MRS. MARY CORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024170052
VA
363LA2200X
Adult Health Nurse Practitioner
SP010632
PA
Other
Enumeration date
12/08/2009
Last updated
12/19/2012
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