Individual
MRS. MAITE JACQUAY CORBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
46440 BENEDICT DRIVE , SUITE 107, STERLING, VA 20164-6602
(703) 450-1125
(703) 450-1145
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-3346
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024177940
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275188559
—
VA
05
—
30017438120001
—
VA
Enumeration date
08/05/2019
Last updated
03/06/2024
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