Basic Information
| Provider Information | |||||||||
| NPI: | 1457829327 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORKILL | ||||||||
| FirstName: | EMMA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15901 W 127TH ST APT 222 | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660625107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3095252875 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10700 NALL AVE | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135881227 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2018 | ||||||||
| LastUpdateDate: | 11/08/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.