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General NPI Number Information
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NPI Number | 1962410720
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Entity Type | Individual
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Provider Name | BENITA SUZETTE CORBITT-CHERRY ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2133 BROADWAY AVE
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City | JACKSONVILLE
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State | FL
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Zip | 32209-7513
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Country | US
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Telephone | 904-665-2650
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Fax | 904-665-1789
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Provider Business Mailing Address
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Address Line | 515 W 6TH ST MC #24
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City | JACKSONVILLE
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State | FL
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Zip | 32206-4324
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Country | US
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Telephone | 904-665-2410
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Fax | 904-630-3316
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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 | ARNP3028282
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License Number State | FL
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