Healthcare Provider Details

I. General information

NPI: 1134989361
Provider Name (Legal Business Name): NAOMI MELISSA CORBI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2024
Last Update Date: 03/31/2024
Certification Date: 03/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 WILLOW OAKS CORPORATE DR STE 600
FAIRFAX VA
22031-4516
US

IV. Provider business mailing address

PO BOX 935
MC LEAN VA
22101-0935
US

V. Phone/Fax

Practice location:
  • Phone: 203-770-5621
  • Fax: 703-448-0591
Mailing address:
  • Phone: 203-770-5621
  • Fax: 703-448-0591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number95206054
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number153480
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN500009532
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number0001327080
License Number StateVA
# 5
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number0001327080
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: