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General NPI Number Information
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NPI Number | 1285704858
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Entity Type | Individual
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Provider Name | TRACI ANN CORBY ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 12611 WORLD PLAZA LN BLDG 53
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City | FORT MYERS
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State | FL
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Zip | 33907-3990
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Country | US
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Telephone | 239-275-8118
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Fax | 239-275-5914
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Provider Business Mailing Address
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Address Line | 6150 OAK TREE BLVD STE 200
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2569
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Country | US
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Telephone | 239-275-8118
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Fax | 239-275-5914
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 3165972
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License Number State | FL
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