Provider Demographics
NPI:1598759409
Name:CORBIT-DRAKULICH, JANET KATHLEEN (OD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:KATHLEEN
Last Name:CORBIT-DRAKULICH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:K
Other - Last Name:CORBIT-DRAKULICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2874 N CARSON ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0177
Mailing Address - Country:US
Mailing Address - Phone:775-887-8866
Mailing Address - Fax:775-283-3245
Practice Address - Street 1:2874 N CARSON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0177
Practice Address - Country:US
Practice Address - Phone:775-887-8866
Practice Address - Fax:775-283-3245
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV483152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100505566Medicaid
NV39096Medicare PIN
NV100505566Medicaid