Provider Demographics
NPI:1689644312
Name:CORSBERG, CHRISTINE SUSAN (PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:SUSAN
Last Name:CORSBERG
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 OLIVER EDWARDS RD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-6538
Mailing Address - Country:US
Mailing Address - Phone:423-631-1230
Mailing Address - Fax:
Practice Address - Street 1:1805 W STATE OF FRANKLIN RD
Practice Address - Street 2:DEPT OF PHARMACY
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8801
Practice Address - Country:US
Practice Address - Phone:423-631-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist