Provider Demographics
NPI:1629372974
Name:CORBETT, ELIZABETH AMOS (PMHCNS/NP-BC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:AMOS
Last Name:CORBETT
Suffix:
Gender:F
Credentials:PMHCNS/NP-BC
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Mailing Address - Street 1:108 COOKE ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-1122
Mailing Address - Country:US
Mailing Address - Phone:919-755-6930
Mailing Address - Fax:919-851-3555
Practice Address - Street 1:8801 FAST PARK DR STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4853
Practice Address - Country:US
Practice Address - Phone:919-851-1527
Practice Address - Fax:919-851-3555
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5005032363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2595205Medicare PIN