| Doctor Name: | NICOLE P CORK |
| NPI Number: | 1134492721 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BSW |
| License Number: | 8419-120 |
| Business Practice Address: | 1407 Saint Andrew St Ste 100 La Crosse, WI - 546032378 |
| Business Phone Number: | 6087853611 |
| Business Fax Number: | |
| Mailing Address: | W12923 5th St, OSSEO |
| State: | WI |
| Postal Code: | 547587496 |
| Phone Number: | 7155331164 |
| Fax Number: | |
| NPI Enumeration Date: | 02/14/2012 |
| NPI Last Update Date: | 02/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171M00000X |
| License Number: | 8419-120 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Case Manager/Care Coordinator |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee |