Tasha Corinth, PA
Individual provider Active NPI Physician Assistant · Eagle River, AK
NPI 1669745865 · NPPES record last updated Feb 17, 2012
Key facts
- NPI
- 1669745865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2173 (AK)
- Practice address
- 11432 Business Blvd Ste 4
Eagle River, AK 99577-7740 - Phone
- (907) 694-1300
- NPI assigned
- Feb 17, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2173 | AK | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2173 | AK | Yes |
Addresses
Primary practice location
11432 Business Blvd Ste 4
Eagle River, AK 99577-7740
Mailing address
11432 Business Blvd Ste 4
Eagle River, AK 99577-7740
Phone (907) 694-1300
Other providers in Eagle River, AK
- Olivia Colon
- Teresa Comer
- Elizabeth Anne Commissaris
- Bill Campbell Compton
- Audrey Conrad
- Denis Salvador Corral
- Andrea B Cortes Sierra
- Daniel John Coverdell
- Lubov M Coverdell
- Steven Covington
All providers in Eagle River, AK · Physician Assistant in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2012. 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.