MEDICARE: MS. ELIZABETH AMOS CORBETT PMHCNS/NP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	5005032	NC

General Provider Information

NPI Number	:	1629372974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH AMOS CORBETT PMHCNS/NP-BC

Provider Business Mailing Address
First Line	:	108 COOKE ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27601-1122
Country	:	US
Telephone Number	:	919-755-6930
Fax Number	:	919-851-3555

Provider Business Practice Location Address
First Line	:	8801 FAST PARK DR STE 107
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-4853
Country	:	US
Telephone Number	:	919-851-1527
Fax Number	:	919-851-3555

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

Provider Enumeration Date	:	12/30/2010
Last Update Date	:	02/10/2019

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