Provider Demographics
NPI:1538114533
Name:CORZINE, GILLIAN MAY (MS)
Entity Type:Individual
Prefix:
First Name:GILLIAN
Middle Name:MAY
Last Name:CORZINE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 BALDWINS XING
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-5169
Mailing Address - Country:US
Mailing Address - Phone:919-942-7132
Mailing Address - Fax:
Practice Address - Street 1:104 JONES FERRY RD
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2036
Practice Address - Country:US
Practice Address - Phone:919-960-9912
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC659174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist