Individual
CAROLYN KORFIATIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
85 SIERRA PARK RD, MAMMOTH LAKES, CA 93546-2073
(509) 205-1503
Mailing address
PO BOX 660, MAMMOTH LAKES, CA 93546-0660
(509) 205-1503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
672701-1
NY
163W00000X
Registered Nurse
95036715
CA
363LF0000X
Family Nurse Practitioner
Primary
95002589
CA
Other
Enumeration date
03/11/2014
Last updated
06/30/2015
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