Provider Demographics
NPI:1154875037
Name:CORWIN, CATHRINE ANN (CPNP-AC)
Entity type:Individual
Prefix:
First Name:CATHRINE
Middle Name:ANN
Last Name:CORWIN
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2797 SAGEBRUSH CIR
Mailing Address - Street 2:APT 202
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8766
Mailing Address - Country:US
Mailing Address - Phone:616-485-7510
Mailing Address - Fax:
Practice Address - Street 1:411 W LAKE LANSING RD
Practice Address - Street 2:SUITE C120
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8445
Practice Address - Country:US
Practice Address - Phone:517-337-0957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704303500363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics