Basic Information
| Provider Information | |||||||||
| NPI: | 1891201851 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCANLON | ||||||||
| FirstName: | CORIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 COMMERCE ST STE 700 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372011835 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154549850 | ||||||||
| FaxNumber: | 8884942588 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 CEDAR RIDGE DR STE 212 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152059692 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123074609 | ||||||||
| FaxNumber: | 8557375542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2017 | ||||||||
| LastUpdateDate: | 12/28/2017 | ||||||||
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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 | 363LF0000X | SP018351 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.