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NPI Code Detail

MEDICARE: MS. PATRICIA ANN CORBETT NP

MEDICARE: MS. PATRICIA ANN CORBETT 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
1363L00000XNurse Practitioner71001141AIN
2363LW0102XWomen's Health Nurse Practitioner71001141AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4500029743OTHERINRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000789430OTHERINBCBS CENTENNIAL
2000000365101OTHERINBCBS BMG CENTRAL
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699763409
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA ANN CORBETT NP
Provider Business Mailing Address
First Line : 710 N NILES AVE
Second Line :
City : SOUTH BEND
State : IN
Zip : 46617-1924
Country : US
Telephone Number : 574-647-1610
Fax Number :
Provider Business Practice Location Address
First Line : 1708 HIGH ST
Second Line :
City : SOUTH BEND
State : IN
Zip : 46613-2633
Country : US
Telephone Number : 574-400-4418
Fax Number : 574-232-9550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 02/01/2019

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Directions to “ MS. PATRICIA ANN CORBETT NP” Practice Location

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