Healthcare Provider Details

I. General information

NPI: 1235074881
Provider Name (Legal Business Name): TYEISHA CORBITT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192B COUNTY ROAD 200
PITTSBORO MS
38951-9773
US

IV. Provider business mailing address

PO BOX 51
PITTSBORO MS
38951-0051
US

V. Phone/Fax

Practice location:
  • Phone: 662-800-8322
  • Fax:
Mailing address:
  • Phone: 662-800-8322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: