Individual
KRISTEN BLAKE COREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10650 PARK RD, CHARLOTTE, NC 28210-8538
(704) 667-3960
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2022-01463
NC
207KA0200X
Allergy Physician
2022-01463
NC
208000000X
Pediatrics Physician
2022-01463
NC
2080P0201X
Pediatric Allergy/Immunology Physician
2022-01463
NC
Other
Enumeration date
04/03/2017
Last updated
07/15/2024
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