Provider Demographics
NPI:1720186661
Name:CORBETT, KATHLEEN T (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:T
Last Name:CORBETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 2ND AVE N
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5756
Mailing Address - Country:US
Mailing Address - Phone:239-261-8188
Mailing Address - Fax:239-261-9144
Practice Address - Street 1:700 2ND AVE N
Practice Address - Street 2:SUITE 302
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5756
Practice Address - Country:US
Practice Address - Phone:239-261-8188
Practice Address - Fax:239-261-9144
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3087792163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS81545Medicare UPIN
FLY7059ZMedicare ID - Type Unspecified