Corey, Mark

Corey, Mark is an individual health care provider with primary practice located at 110 Main St , Moro OR 97039-3080. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Community Health, which is considered as his primary health care specialty. Corey, Mark can be contacted via phone (541) 565-3325.

Contact Information

Primary practice address
110 Main St Moro OR 97039-3080
Phone: (541) 565-3325
Fax: (541) 565-3617
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Community Health 363LC1500X 093007080N1 Oregon

Profile Details

NPI number 1851372643
LBN Legal business name Corey, Mark
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Mar 27th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851372643 NPPES
Oregon MEDICAID 023015

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