Individual
TRACI CORBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
411 TOWN PARK BLVD, EVANS, GA 30809-3487
(706) 854-2500
(706) 854-2534
Mailing address
501 FURYS FERRY RD, AUGUSTA, GA 30907-9059
(762) 685-5501
(706) 750-9229
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
RN261681
GA
363L00000X
Nurse Practitioner
Primary
RN261681
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003190470C
—
GA
Enumeration date
12/14/2016
Last updated
01/30/2024
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