Corinna D. Bynum, RN
Individual provider Active NPI Administrator Registered Nurse · Campo, CA
NPI 1043910508 · NPPES record last updated Nov 15, 2024
Key facts
- NPI
- 1043910508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Administrator Registered Nurse 163WA2000X
- License
- RN95177050 (CA)
- Practice address
- 1777 Buckman Springs Rd
Campo, CA 91906-2022 - Phone
- (619) 478-5696
- NPI assigned
- Mar 3, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN95177050 | CA | MD | Administrator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Diego Freedom Ranch, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | RN95177050 | CA | Yes |
Addresses
Primary practice location
1777 Buckman Springs Rd
Campo, CA 91906-2022
Mailing address
1777 Buckman Springs Rd
Campo, CA 91906-2022
Phone (707) 826-8633
Other providers in Campo, CA
- Peter Murray Baum
- Matteson Brickner
- Brandon Scott Brown
- Joshua Steven Bruce
- Bryan S Burke
- Jeanette Cabanilla
- Chantal Camarena
- Ann Carter
- Corey Adam Cartwright
- Centro de Salud de la Comunidad de San Ysidro Inc
All providers in Campo, CA · Administrator Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.