MEDICARE: MS. SHERITTE VERNEE CORBIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician		NC

General Provider Information

NPI Number	:	1558144766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHERITTE VERNEE CORBIN

Provider Business Mailing Address
First Line	:	316 BEACON HILLS DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28056-8369
Country	:	US
Telephone Number	:	704-685-5905
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 BEACON HILLS DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28056-8369
Country	:	US
Telephone Number	:	704-685-5905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	08/14/2023

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