Provider Demographics
NPI:1396384509
Name:CORBITT, MARY H (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:H
Last Name:CORBITT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RYANS CT
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-3477
Mailing Address - Country:US
Mailing Address - Phone:770-301-2005
Mailing Address - Fax:
Practice Address - Street 1:210 CLOVER REACH
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1657
Practice Address - Country:US
Practice Address - Phone:770-487-9604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN248138207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology