KELLEY BROOKE CORL NP-C
Complete NPI Record 1699374371
Nurse Practitioner in Prescott, AZ
Active since October 22, 2020PECOS Enrolled
Complete NPI Dataset
This page contains the complete raw NPPES record for Kelley Brooke Corl, NP-C (NPI 1699374371), an individual nurse practitioner provider in Prescott, AZ. All 33 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1699374371 Field 1/33
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/33
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: CORL Field 3/33
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: KELLEY Field 4/33
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: BROOKE Field 5/33
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: NP-C Field 6/33
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: PO BOX 211699 Field 7/33
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: EAGAN Field 8/33
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MN Field 9/33
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 551213699 Field 10/33
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/33
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 8668490692 Field 12/33
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 8889738821 Field 13/33
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 3623 CROSSINGS DR STE 206 Field 14/33
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: PRESCOTT Field 15/33
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: AZ Field 16/33
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 863057101 Field 17/33
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/33
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 8668490692 Field 19/33
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 8889738821 Field 20/33
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 23/33
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363L00000X Field 24/33
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: C-APN.0103359-C-NP Field 25/33
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: CO Field 26/33
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 27/33
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 363L00000X Field 28/33
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: RNP248594 Field 29/33
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: AZ Field 30/33
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: Y Field 31/33
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N Field 32/33
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 10
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
2122 E Highland Ave Ste 265
Location 1/10Phoenix, AZ 85016-4779 · Phone (833) 696-3349
3800 W Ray Rd Ste 21
Location 2/10Chandler, AZ 85226-5940 · Phone (833) 696-3349
5605 W Eugie Ave Ste 210
Location 3/10Glendale, AZ 85304-1275 · Phone (833) 696-3349
5601 W Eugie Ave Ste 211
Location 4/10Glendale, AZ 85304-1258 · Phone (833) 696-3349
3805 E Bell Rd Ste 2400
Location 5/10Phoenix, AZ 85032-2181 · Phone (833) 696-3349
4400 N 32nd St Ste 150
Location 6/10Phoenix, AZ 85018-3977 · Phone (833) 696-3349
3805 E Bell Rd Ste 5600
Location 7/10Phoenix, AZ 85032-2190 · Phone (833) 696-3349
7406 N La Cholla Blvd
Location 8/10Tucson, AZ 85741-2306 · Phone (833) 696-3349
16435 N Scottsdale Rd Ste 285
Location 9/10Scottsdale, AZ 85254-1680 · Phone (866) 849-0692
2918 W Ina Rd Ste 100
Location 10/10Tucson, AZ 85741-2429 · Phone (833) 696-3349
No registry entries match your active lookup criteria.
