Provider Demographics
NPI:1295306405
Name:CORBETT, RACHEL (APRN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:CORBETT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 TALL PINES DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3857
Mailing Address - Country:US
Mailing Address - Phone:801-995-1765
Mailing Address - Fax:
Practice Address - Street 1:508 S HABANA AVE STE 340
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4191
Practice Address - Country:US
Practice Address - Phone:813-873-7367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014079363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics