Individual
MARY LIN CORBETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPC-NP
Contact information
Practice address
1120 CRISTLAND RD, LOUISVILLE, KY 40214-4150
(502) 367-0104
(502) 358-5208
Mailing address
12201 BLUEGRASS PKWY, LOUISVILLE, KY 40299-2361
(502) 568-7364
(502) 568-7136
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3010355
KY
363LG0600X
Gerontology Nurse Practitioner
3010355
KY
Other
Enumeration date
08/11/2016
Last updated
08/11/2016
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