Basic Information
| Provider Information | |||||||||
| NPI: | 1386877579 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORRIGAN | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | LYNNE | ||||||||
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| Credential: | FNP-BC, CNN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2160 | ||||||||
| Address2: | |||||||||
| City: | MOORPARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930202160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187182301 | ||||||||
| FaxNumber: | 8187182311 | ||||||||
| Practice Location | |||||||||
| Address1: | 375 ROLLING OAKS DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | THOUSAND OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913611024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054977775 | ||||||||
| FaxNumber: | 8055571074 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2009 | ||||||||
| LastUpdateDate: | 11/30/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WD1100X | NP19226 | CA | N | Nursing Service Providers | Registered Nurse | Dialysis, Peritoneal | 363LF0000X | 19226 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.