Provider Demographics
NPI:1104156199
Name:CORBO, KATHY ANNE (ARNP)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:ANNE
Last Name:CORBO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1002 S HARBOUR ISLAND BLVD
Mailing Address - Street 2:UNIT #1610
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5781
Mailing Address - Country:US
Mailing Address - Phone:941-587-1386
Mailing Address - Fax:727-733-9233
Practice Address - Street 1:1064 KEENE RD
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6300
Practice Address - Country:US
Practice Address - Phone:727-733-9202
Practice Address - Fax:727-733-9202
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3308452363LA2200X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health