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General NPI Number Information
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NPI Number | 1962824433
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Entity Type | Individual
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Provider Name | LAURA ANN CORBIN PA
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Gender | Female
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 220 S ELM ST STE 200
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City | JENKS
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State | OK
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Zip | 74037-3701
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Country | US
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Telephone | 918-403-7144
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Fax | 918-856-5561
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Provider Business Mailing Address
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Address Line | 1923 S UTICA AVE
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City | TULSA
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State | OK
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Zip | 74104-6520
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Country | US
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Telephone | 918-403-7065
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Fax | 918-744-2946
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2357
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License Number State | OK
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