KATRINA CORLISS (NPI# 1013383934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013383934 |
| Entity Type | Individual |
| Full Name | KATRINA CORLISS |
| Credential | MT |
| Practice Address |
29 Black Coal Rd Laboratory Ft Washacki WY 82514 |
| Mailing Address |
3223 E Stage Rd Ionia MI 48846-9718 |
| Practice Telephone | 3073355973 |
| Practice Fax Number | 3073327514 |
| Mailing Telephone | 3073303012 |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QM0706X |
Spec/Tech, Pathology Specialization: Medical Technologist |
AAB 2050187 | MI | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
29 BLACK COAL RD LABORATORY |
| City | FT WASHACKI |
| State | WY |
| Zip Code | 82514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527819 | Melissa Rose Pine | Registered Nurse | 29 Blackcole Road, Fort Washakie, WY 82514 | 2019-09-19 |
| 1982116794 | Madonna Lee Kienlen | Peer Specialist | 215 Ethete Road, Ft. Washakie, WY 82514 | 2017-11-02 |
| 1649789025 | Rebecca Charlene Willis | Technician, Other | Fort Washakie Healt Center Lab Ihs 29 Black Coal Drive, Fort Washakie, WY 82514 | 2017-09-28 |
| 1033553185 | Pauline Elizabeth Powers-peprah | Family Medicine | 29 Black Cole, Fort Washakie, WY 82514 | 2013-04-19 |
| 1528319373 | Amanda L Schultz | Licensed Practical Nurse | 110 Sharpnose Road, Fort Washakie, WY 82514 | 2012-09-19 |
| 1770898140 | Kelly Lynne Pretty Weasel | Clinic/Center | 29 Blackcole Dr, Fort Washakie, WY 82514 | 2010-08-10 |
| 1285950170 | Debra Kay Waters | Technician, Pathology | Black Coal Rd. Bldg. 29, Ft. Washakie, WY 82514 | 2010-04-16 |
| 1881919751 | Shoshone & Arapaho Tribal Substance Abuse Court | Clinic/Center | 215 Ethete Rd, Fort Washakie, WY 82514 | 2010-04-02 |
| 1922339449 | Nina Williams | Spec/Tech, Pathology | Black Coal Rd Bldg 29, Ft Washakie, WY 82514 | 2010-01-22 |
| 1821329459 | Karen Fay Gibson | Clinical Medical Laboratory | 29 Blackcoal Dr., Laboratory, Fort Washakie, WY 82514 | 2010-01-21 |
| Find all providers in zip 82514 | ||||
| Taxonomy Code | 246QM0706X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| Specialization | Medical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477893253 | Mindy Rae Pomeroy | Spec/Tech, Pathology | 14 Great Plains Rd., Arapaho, WY 82510 | 2013-02-15 |
| 1770814253 | Christopher G Nelson | Spec/Tech, Pathology | 29 Black Coal Rd, Ft. Washakie, WY 82514 | 2010-01-22 |
| 1922339449 | Nina Williams | Spec/Tech, Pathology | Black Coal Rd Bldg 29, Ft Washakie, WY 82514 | 2010-01-22 |
| 1205388329 | Michael Steele | Spec/Tech, Pathology | 14 Great Plains Rd., Arapahoe, WY 82510 | 2016-10-25 |
| 1679029474 | Corina Teves | Spec/Tech, Pathology | 14 Great Plains Rd, Arapahoe, WY 82510 | 2016-08-31 |
| 1205235330 | David Thatch | Spec/Tech, Pathology | 29 Black Coal Drive, Fort Washakie, WY 82514 | 2014-08-14 |
| 1568713311 | Erica Rose Golon | Spec/Tech, Pathology | 29 Black Coal Road, Fort Washakie, WY 82514 | 2012-09-19 |
| 1689963233 | Becky Bappe | Spec/Tech, Pathology | 29 Black Coal Drive, Fort Washakie Health Center Lab, Fort Washakie, WY 82514 | 2011-04-05 |
| 1508172511 | Alvinita Lamebull | Spec/Tech, Pathology | Black Coal Rd Bldg 29, Fort Washakie, WY 82514-0128 | 2010-08-27 |
| 1720390479 | Caryl B Parks | Spec/Tech, Pathology | 29 Black Coal Rd, Laboratory, Fort Washakie, WY 82514-0128 | 2010-07-10 |
| Find all providers with the same taxonomy | ||||
| City | FT WASHACKI |
| Zip Code | 82514 |
Please comment or provide details below to improve the information on KATRINA CORLISS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.