Individual
CHANTELL CORKERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1808 W MAIN ST, RUSSELLVILLE, AR 72801-2724
(479) 968-2841
Mailing address
2107 W 5TH ST, RUSSELLVILLE, AR 72801-5684
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
123620
AR
363LF0000X
Family Nurse Practitioner
Primary
123620
AR
Other
Enumeration date
12/09/2020
Last updated
02/16/2021
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