Individual
MRS. SHANNON MARIE CORCUERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, ACNPC-AG
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7550
Mailing address
1310 24TH AVE S, NASHVILLE, TN 37212-2637
(615) 327-4751
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
32571
TN
Other
Enumeration date
01/20/2023
Last updated
09/28/2023
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