Provider Demographics
NPI:1487688289
Name:PAPALIA, CORELLA LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:CORELLA
Middle Name:LYNN
Last Name:PAPALIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1307
Mailing Address - Country:US
Mailing Address - Phone:317-773-4482
Mailing Address - Fax:
Practice Address - Street 1:160 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1307
Practice Address - Country:US
Practice Address - Phone:317-773-4482
Practice Address - Fax:317-776-2520
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003285A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INV01962Medicare UPIN
IN5587880001Medicare NSC
IN232710BMedicare PIN