Provider Demographics
NPI:1588873202
Name:CORBIN, PATRICIA L (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
Last Name:CORBIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4394 STRAIGHT ARROW RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1690
Mailing Address - Country:US
Mailing Address - Phone:937-426-3514
Mailing Address - Fax:937-426-3514
Practice Address - Street 1:4394 STRAIGHT ARROW RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45430-1690
Practice Address - Country:US
Practice Address - Phone:937-426-3514
Practice Address - Fax:937-426-3514
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.332543163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2547275Medicaid