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NPI Code Detail

MEDICARE: KATHLEEN ANN CORBO NP

MEDICARE: KATHLEEN ANN CORBO NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner212657MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134170889
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN ANN CORBO NP
Provider Business Mailing Address
First Line : 75 MOUNT AUBURN ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-4960
Country : US
Telephone Number : 617-495-2001
Fax Number : 617-496-0530
Provider Business Practice Location Address
First Line : 75 MOUNT AUBURN ST
Second Line : HARVARD UNIVERSITY HEALTH SERVICES
City : CAMBRIDGE
State : MA
Zip : 02138-4960
Country : US
Telephone Number : 617-495-2001
Fax Number : 617-496-0530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 01/16/2015

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