Provider Demographics
NPI:1619537388
Name:CORBETT, GERALDINE MARY (RN)
Entity Type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:MARY
Last Name:CORBETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:GERALDINE
Other - Middle Name:MARY
Other - Last Name:WICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11916 STANSBURY DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6219
Mailing Address - Country:US
Mailing Address - Phone:571-201-7305
Mailing Address - Fax:
Practice Address - Street 1:11916 STANSBURY DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6219
Practice Address - Country:US
Practice Address - Phone:571-201-7305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-15
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001173546163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse