Maureen Egan Corl, NP

Individual provider Active NPI Adult Health Nurse Practitioner · Cincinnati, OH

NPI 1639411010 · NPPES record last updated Sep 2, 2016

Key facts

NPI
1639411010
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
14066-NP (OH)
Practice address
2123 Auburn Avenue
Su. 139
Cincinnati, OH 45219-2609
Phone
(513) 206-1170
Fax
(513) 206-1172
NPI assigned
Mar 22, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-14066OHMDNurse Practitioner
14066-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, LLC Nurse Practitioner Past Accepting new patients
Middletown Emergency Physicians, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP-14066 OH
Adult Health Nurse Practitioner 363LA2200X 14066-NP OH Yes

Addresses

Primary practice location

2123 Auburn Avenue
Su. 139
Cincinnati, OH 45219-2609

Mailing address

237 William Howard Taft
2ND Floor, Cbo 2-3
Cincinnati, OH 45219-2609
Phone (513) 206-1170

Other providers in Cincinnati, OH

All providers in Cincinnati, OH · Adult Health Nurse Practitioner in Ohio

Sources for this page

Verify at the official NPI Registry.