Individual
ELIZABETH ANNE CORBELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1301 CAMELLIA BLVD, SUITE 102, LAFAYETTE, LA 70508-7089
(337) 233-3201
Mailing address
1301 CAMELLIA BLVD, SUITE 102, LAFAYETTE, LA 70508-7089
(337) 233-3201
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.INTE.PERMIT
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2113925
—
LA
Enumeration date
10/09/2007
Last updated
01/12/2015
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