Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 01083860A | IN |
NPI | 1003270257 |
---|---|
Provider Name | Corinne Mbakop |
First Address | Evansville, IN 47706-1510 |
Second Address | Evansville, IN 47710-1617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2016 |
Last Update Date | 07/08/2020 |