Provider Demographics
NPI:1588622039
Name:CORBITT, LAURIE LYNNE (ANP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:LYNNE
Last Name:CORBITT
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:LYNNE
Other - Last Name:STEPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:2708 RIFE MEDICAL LN
Mailing Address - Street 2:SUITE T40
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:479-338-4000
Mailing Address - Fax:479-338-4050
Practice Address - Street 1:2708 RIFE MEDICAL LN
Practice Address - Street 2:SUITE T40
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-4000
Practice Address - Fax:479-338-4050
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01077363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR135882758Medicaid
AR5T985Medicare ID - Type Unspecified
AR135882758Medicaid