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NPI Code Detail

MEDICARE: MISTY CORBIN FNP

MEDICARE: MISTY CORBIN FNP
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 Practitioner112042WV
2163WS0200XSchool Registered Nurse55083WV

General Provider Information

NPI Number : 1932647815
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISTY CORBIN FNP
Provider Business Mailing Address
First Line : 111 S GROVE ST STE 1
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-1805
Country : US
Telephone Number : 304-257-2451
Fax Number : 304-257-1263
Provider Business Practice Location Address
First Line : 111 S GROVE ST STE 1
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-1805
Country : US
Telephone Number : 304-257-2451
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2017
Last Update Date : 03/18/2022

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1760906838 — HEATHER JANE BARGER APRN, FNP-BC
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Directions to “ MISTY CORBIN FNP” Practice Location

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