Provider Demographics
NPI:1699919365
Name:CORELL, VICTORIA M (CNP)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:M
Last Name:CORELL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:CARRANZA
Other - Last Name:CORELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:26640 BUTTERNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-4405
Mailing Address - Country:US
Mailing Address - Phone:440-779-8109
Mailing Address - Fax:
Practice Address - Street 1:18101 LORAIN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5612
Practice Address - Country:US
Practice Address - Phone:216-476-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-26
Last Update Date:2009-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-10382363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health