Provider Demographics
NPI:1720097389
Name:KORBITZ, DEBORAH S (CNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:KORBITZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:S
Other - Last Name:BJERSTEDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:10238 E HAMPTON AVE STE 416
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3320
Mailing Address - Country:US
Mailing Address - Phone:480-561-5000
Mailing Address - Fax:
Practice Address - Street 1:10238 E HAMPTON AVE STE 416
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3320
Practice Address - Country:US
Practice Address - Phone:480-561-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5429363LF0000X
AZ2952363LF0000X
AZAP2952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1720097389Medicaid
AZZ132194Medicare PIN