Healthcare Provider Details

I. General information

NPI: 1710499124
Provider Name (Legal Business Name): NATALIY V CORBIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 12/10/2019
Certification Date: 12/10/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HUFFMAN MILL RD
BURLINGTON NC
27215-8862
US

IV. Provider business mailing address

120 WILLIAM PENN PLZ
DURHAM NC
27704-2150
US

V. Phone/Fax

Practice location:
  • Phone: 336-584-5544
  • Fax: 919-313-1276
Mailing address:
  • Phone: 919-220-5255
  • Fax: 919-313-1276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5010025
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: