Individual
COREY HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 660-2450
Mailing address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
95014737
CA
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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