Provider Demographics
NPI:1104177658
Name:CORBETT, CHRISTINE D (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:D
Last Name:CORBETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 HICKORY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7330
Mailing Address - Country:US
Mailing Address - Phone:704-843-4502
Mailing Address - Fax:
Practice Address - Street 1:6300 MONROE WEDDINGTON RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-7925
Practice Address - Country:US
Practice Address - Phone:704-843-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist