Duckworth, Correena Lorraine

Duckworth, Correena Lorraine is an individual health care provider with primary practice located at Po Box 4000 , Polacca AZ 86042-4000. She recently has only one registered license in Nursing Service Providers / Emergency, which is considered as her primary health care specialty. Duckworth, Correena Lorraine can be contacted via phone (928) 737-6000.

Contact Information

Primary practice address
Po Box 4000 Polacca AZ 86042-4000
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X RN123469 Georgia

Profile Details

NPI number 1700397635
LBN Legal business name Duckworth, Correena Lorraine
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2017
Last updated Oct 18th, 2017 - about 7 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 1700397635 NPPES
Arizona MEDICAID 020529

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