SANDRA LYNNE CORRIGAN, FNP-BC, CNN - NPI NUMBER 1386877579

Summary

Provider Name: SANDRA LYNNE CORRIGAN, FNP-BC, CNN

NPI Number: 1386877579

Clasification: Registered Nurse (163WD1100X)

Specialization: Dialysis, Peritoneal

Organization: CALIFORNIA KIDNEY MEDICAL GROUP INC

Address:
375 ROLLING OAKS DR STE 100
THOUSAND OAKS, CA
ZIP 91361

Phone Number: (805) 497-7775



Detailed Information

Sandra Lynne Corrigan, FNP-BC, CNN is a peritoneal registered nurse in Thousand Oaks, CA with 6 years of experience. The assigned NPI number for this provider is 1386877579 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

375 ROLLING OAKS DR STE 100
THOUSAND OAKS, CA
ZIP 91361-024
Phone: (805) 497-7775
Fax: (805) 557-1074

The enumeration date for this NPI number is 9/3/2009 and was last updated on 1/31/2013.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 163WD1100X Registered Nurse Dialysis, Peritoneal NP19226 CA No
2 363LF0000X Nurse Practitioner Family 19226 CA Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1386877579 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name CORRIGAN The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name SANDRA The first name of the provider, if the provider is an individual.
5 Provider Middle Name LYNNE The middle name of the provider, if the provider is an individual.
6 Provider Credential Text FNP-BC, CNN The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7 Provider First Line Business Practice Location Address 375 ROLLING OAKS DR STE 100 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name THOUSAND OAKS The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name CA The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 913611024 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 8054977775 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 8055571074 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 9/3/2009 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 1/31/2013 The date that a record was last updated or changed.
16 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 163WD1100X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Provider License Number 1 NP19226 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
19 Provider License Number State Code 1 CA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
20 Healthcare Provider Primary Taxonomy Switch 1 N
21 Healthcare Provider Taxonomy Code 2 363LF0000X
22 Provider License Number 2 19226 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Provider License Number State Code 2 CA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
24 Healthcare Provider Primary Taxonomy Switch 2 Y
25 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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