Provider Demographics
NPI:1730078882
Name:CORBETT, KELLEY MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:MARIE
Last Name:CORBETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 LITTLE SORREL DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4407
Mailing Address - Country:US
Mailing Address - Phone:703-595-9229
Mailing Address - Fax:
Practice Address - Street 1:1001 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5075
Practice Address - Country:US
Practice Address - Phone:804-828-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193913363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner