Provider Demographics
NPI:1174107957
Name:CORBETT, TORIE B
Entity type:Individual
Prefix:
First Name:TORIE
Middle Name:B
Last Name:CORBETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8552 APRIL ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-1050
Mailing Address - Country:US
Mailing Address - Phone:901-620-7300
Mailing Address - Fax:
Practice Address - Street 1:8552 APRIL ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-1050
Practice Address - Country:US
Practice Address - Phone:901-620-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health