Provider Demographics
NPI:1629279278
Name:CORBIN, BRENDA KAY (ARNP/ FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:CORBIN
Suffix:
Gender:F
Credentials:ARNP/ FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:228 PONTE VEDRA PARK DR STE 500
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-6611
Practice Address - Country:US
Practice Address - Phone:904-273-1180
Practice Address - Fax:904-273-6116
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2931302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily