Individual
DR. NICHOLLE DIANE CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
323 W BROADWAY, PLAINVIEW, MN 55964-1255
(507) 534-2600
Mailing address
323 W BROADWAY, PO BOX 665, PLAINVIEW, MN 55964-1255
(507) 534-2600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4779
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
491P9CO
BCBS INDIVIDUAL NUMBER
MN
05
—
876455000
—
MN
Enumeration date
03/05/2007
Last updated
12/19/2012
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