Individual
CORREENA LORRAINE DUCKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 4000, POLACCA, AZ 86042-4000
(928) 737-6000
Mailing address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042
(928) 737-6000
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN123469
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
10/18/2017
Last updated
10/18/2017
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