Corinne Monique Hertsel
Nurse Practitioner, Family in Syracuse, IN. Individual provider (NPI-1).
NPI number1164064119
StatusActive
Last updated in NPPESOct 10, 2019
Details
- NPI
- 1164064119
- Entity type
- Individual (NPI-1)
- Name
- Corinne Monique Hertsel
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 10, 2019
- Last updated
- Oct 10, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 71009435A | IN | Yes |
| 163W00000X | Registered Nurse | 28173822A | IN |
Other names
- Corinne Monique Shields (Former Name)
Practice location
107 W Pickwick Dr Ste ASyracuse, IN 46567-1832
Phone 574-457-8585 · Fax 260-479-2913
Mailing address
107 W Pickwick Dr Ste ASyracuse, IN 46567-1832
Phone 574-457-8585 · Fax 260-479-2913
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