Provider Demographics
NPI:1265626089
Name:CORBITT, COURTNEY PATRICE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:PATRICE
Last Name:CORBITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W ARCHER ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-1807
Mailing Address - Country:US
Mailing Address - Phone:918-583-5588
Mailing Address - Fax:918-583-6745
Practice Address - Street 1:415 W ARCHER ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-1807
Practice Address - Country:US
Practice Address - Phone:918-583-5588
Practice Address - Fax:918-583-6745
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator