Most Relevant Information
Provider Data
| NPI Number: | 1003582594 |
| Provider Name: | NICOLE BRICE CORLYON |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 348152 |
Most Important Dates
| Enumeration Date: | 08/17/2021 |
| Last Updated: | 08/17/2021 |
Provider Practice Location
8324 OSWEGO RD STE D
LIVERPOOL
NY
130901086
Practice Location Phone/Fax
| Phone: | 3156526551 |
| Fax: | 3156527039 |
Provider Mailing Location
8324 OSWEGO RD STE D
LIVERPOOL
NY
130901086
Provider Mailing Phone/Fax
| Phone: | 3156526551 |
| Fax: | 3156527039 |