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ESMERALDA CORONADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1301 KS HWY 264, LARNED, KS 67550-9365
(620) 804-2171
Mailing address
1301 KS HWY 264, LARNED, KS 67550-9365
(620) 804-2171

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
08-00291
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0800291
LICENSE NUMBER
KS
01
105778
INDIVIDUAL PROVIDER NUMBE
KS
Enumeration date
09/30/2006
Last updated
09/21/2012
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