Provider Demographics
NPI:1336883081
Name:CORBETT, KAYLA BOLEY (DO, MS)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:BOLEY
Last Name:CORBETT
Suffix:
Gender:F
Credentials:DO, MS
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:NICOLE
Other - Last Name:BOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PEDIATRIC EDUCATION OFFICE CAMPUS BOX 7593
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7593
Mailing Address - Country:US
Mailing Address - Phone:919-966-3172
Mailing Address - Fax:919-966-8419
Practice Address - Street 1:6013 FARRINGTON RD STE 301
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8173
Practice Address - Country:US
Practice Address - Phone:984-974-6669
Practice Address - Fax:984-974-9609
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program