Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 16208 | AR |
NPI | 1982162103 |
---|---|
Provider Name | Caitlin Haley Corona |
First Address | Quitman, AR 72131-0335 |
Second Address | Quitman, AR 72131-8607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2019 |
Last Update Date | 06/03/2019 |