Individual
KEISHA CORBETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3580 NC 14, REIDSVILLE, NC 27320-8746
(336) 522-5095
Mailing address
708 IRVING AVE, EDEN, NC 27288-5618
(336) 344-5870
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
324434
NC
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
323434
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323434
—
NC
Enumeration date
10/07/2020
Last updated
10/07/2020
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