Individual
MS. PATRICIA ANN CORBETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1708 HIGH ST, SOUTH BEND, IN 46613-2633
(574) 400-4418
(574) 232-9550
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71001141A
IN
363LW0102X
Women's Health Nurse Practitioner
Primary
71001141A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000365101
BCBS BMG CENTRAL
IN
01
—
000000789430
BCBS CENTENNIAL
IN
05
—
200044860
—
IN
01
—
500029743
RR MEDICARE
IN
Enumeration date
10/06/2005
Last updated
02/01/2019
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