Provider Demographics
NPI:1811686793
Name:CORLEY-GOLDBERG, BETH SARAH (BSN, RN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:SARAH
Last Name:CORLEY-GOLDBERG
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:SARAH
Other - Last Name:GOLDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:21422 MIDSUMMER WAY
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-5082
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1020 19TH ST NW STE 150
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6103
Practice Address - Country:US
Practice Address - Phone:202-293-5182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN200001943163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant