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Individual
CORI O DAMUTH
Active
Individual
CORI O DAMUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
000166375
VA
363L00000X
Nurse Practitioner
Primary
0024166494
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94929
OPTIMA
VA
Enumeration date
06/24/2005
Last updated
01/17/2019
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