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1134570278
CORISSA VIDAL
CEDAR RAPIDS, IA
NPI
1134570278
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: IA G126019)
Enumeration Date
2016-06-30
Last Update Date
2016-06-30
Business Address
Mrs. CORISSA VIDAL PMHNP-BC
1026 A AVE NE
CEDAR RAPIDS, IA 52402-5036
Phone number: 563-503-0306
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Mailing Address
Mrs. CORISSA VIDAL PMHNP-BC
1026 A AVE NE
CEDAR RAPIDS, IA 52402-5036
Phone number: 563-503-0306
Copy
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