Provider Demographics
NPI:1851697767
Name:CORBETT, EVA J (RN)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:J
Last Name:CORBETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8437 TUTTLE AVE # 303
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2868
Mailing Address - Country:US
Mailing Address - Phone:941-358-7934
Mailing Address - Fax:941-355-4350
Practice Address - Street 1:5476 GOLF POINTE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-3610
Practice Address - Country:US
Practice Address - Phone:941-358-7534
Practice Address - Fax:941-355-4350
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1072342163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY047WOtherBLUE CROSS/BLUE SHIELD OF FLORIDA