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 5 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

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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
1 NPI 1386877579
2 Entity Type Code 1
3 Provider Last Name Legal Name CORRIGAN
4 Provider First Name SANDRA
5 Provider Middle Name LYNNE
6 Provider Credential Text FNP-BC, CNN
7 Provider First Line Business Practice Location Address 375 ROLLING OAKS DR STE 100
8 Provider Business Practice Location Address City Name THOUSAND OAKS
9 Provider Business Practice Location Address State Name CA
10 Provider Business Practice Location Address Postal Code 913611024
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 8054977775
13 Provider Business Practice Location Address Fax Number 8055571074
14 Provider Enumeration Date 9/3/2009
15 Last Update Date 1/31/2013
16 Provider Gender Code F
17 Healthcare Provider Taxonomy Code 1 163WD1100X
18 Provider License Number 1 NP19226
19 Provider License Number State Code 1 CA
20 Healthcare Provider Primary Taxonomy Switch 1 N
21 Healthcare Provider Taxonomy Code 2 363LF0000X
22 Provider License Number 2 19226
23 Provider License Number State Code 2 CA
24 Healthcare Provider Primary Taxonomy Switch 2 Y
25 Is Sole Proprietor N

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This page was last updated on: 4/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.