Individual
CORLISS PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
406 N COTTONWOOD ST, NORFOLK, NE 68701-4210
(402) 644-2546
Mailing address
406 N COTTONWOOD ST, NORFOLK, NE 68701-4210
(402) 644-2546
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
58811
NE
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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