Doctor Name: | LARA KRISTIE KORAL |
NPI Number: | 1235147018 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN MSN |
License Number: | 15900 |
Business Practice Address: | 99 Doctors Dr Munford, TN - 380586305 |
Business Phone Number: | 9018377200 |
Business Fax Number: | 9018374769 |
Mailing Address: | 99 Doctors Dr, MUNFORD |
State: | TN |
Postal Code: | 380586305 |
Phone Number: | 9018377200 |
Fax Number: | 9018374769 |
NPI Enumeration Date: | 08/04/2006 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 15900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |