Provider Demographics
NPI:1386694685
Name:CORBETT, RHONDA LYNN (APRN-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYNN
Last Name:CORBETT
Suffix:
Gender:F
Credentials:APRN-BC, FNP-C
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:LYNN
Other - Last Name:DUKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-BC, FNP-C
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-367-3360
Mailing Address - Fax:502-367-3365
Practice Address - Street 1:1850 BLUEGRASS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1161
Practice Address - Country:US
Practice Address - Phone:502-367-3360
Practice Address - Fax:502-367-3365
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3298P363L00000X, 363LF0000X
KY3003298363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200976550Medicaid
KY78007432Medicaid
KYP01047875OtherMEDICARE RR
KY0927102Medicare ID - Type Unspecified
KYP43021Medicare UPIN
KY00546257Medicare Oscar/Certification