Provider Demographics
NPI:1063119220
Name:CORRIGAN, ALON PADRAIG (PMHNP)
Entity type:Individual
Prefix:
First Name:ALON
Middle Name:PADRAIG
Last Name:CORRIGAN
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22150 BELL HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-3986
Mailing Address - Country:US
Mailing Address - Phone:813-395-4596
Mailing Address - Fax:
Practice Address - Street 1:22150 BELL HARBOR DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-3986
Practice Address - Country:US
Practice Address - Phone:813-395-4596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024242363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health