Healthcare Provider Details

I. General information

NPI: 1265970198
Provider Name (Legal Business Name): DENISE CORBETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE PRESLEY

II. Dates (important events)

Enumeration Date: 02/11/2017
Last Update Date: 12/30/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S MAIN ST
SARDIS MS
38666-1724
US

IV. Provider business mailing address

519 WOODLAND RD
BATESVILLE MS
38606-7331
US

V. Phone/Fax

Practice location:
  • Phone: 662-267-9673
  • Fax:
Mailing address:
  • Phone: 662-267-9673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: