Individual
CORRINE LEE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1510 CAPITOLA RD, SANTA CRUZ, CA 95062-2912
(831) 427-3500
Mailing address
PO BOX 542, SANTA CRUZ, CA 95061-0542
(831) 427-3500
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
NP95001430
CA
Other
Enumeration date
10/07/2014
Last updated
05/10/2024
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