Individual
CORENE KIMBERLY IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
15508 80TH AVENUE CT E, PUYALLUP, WA 98375-8489
(785) 630-0608
Mailing address
15508 80TH AVENUE CT E, PUYALLUP, WA 98375-8489
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
60978206
WA
Other
Enumeration date
08/23/2019
Last updated
11/01/2021
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