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General NPI Number Information
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NPI Number | 1427430586
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Entity Type | Individual
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Provider Name | CASSIE DEESE CORBIN APRN
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Gender | Female
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 2617 MITCHAM DR STE 102
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5479
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Country | US
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Telephone | 850-878-1171
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Fax | 850-942-1291
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Provider Business Mailing Address
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Address Line | 2617 MITCHAM DR STE 102
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City | TALLAHASSEE
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State | FL
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Zip | 32308-5479
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Country | US
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Telephone | 850-878-1171
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Fax | 850-942-1291
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9179861
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License Number State | FL
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