Healthcare Provider Details

I. General information

NPI: 1285998898
Provider Name (Legal Business Name): LAURA MARY CORBITT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7495 STATE RD SUITE 325
CINCINNATI OH
45255-2498
US

IV. Provider business mailing address

7495 STATE RD SUITE 325
CINCINNATI OH
45255-2498
US

V. Phone/Fax

Practice location:
  • Phone: 513-233-2000
  • Fax: 513-624-2684
Mailing address:
  • Phone: 513-233-2000
  • Fax: 513-624-2684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberCOA.13355-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: