MEDICARE: MRS. CHRISTINE M CORBY R.N.

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
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	4704172552	MI

General Provider Information

NPI Number	:	1518977305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE M CORBY R.N.

Provider Business Mailing Address
First Line	:	3202 RABIDUE RD
Second Line	:
City	:	CLYDE
State	:	MI
Zip	:	48049-4106
Country	:	US
Telephone Number	:	810-985-4125
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 MILITARY ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-5416
Country	:	US
Telephone Number	:	810-987-7050
Fax Number	:	810-987-2336

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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