Provider Demographics
NPI:1144061953
Name:CORBITT, BRITTANIA (NP)
Entity type:Individual
Prefix:
First Name:BRITTANIA
Middle Name:
Last Name:CORBITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 STONEWALL BEACH LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6706
Mailing Address - Country:US
Mailing Address - Phone:818-414-8121
Mailing Address - Fax:
Practice Address - Street 1:128 MEDICAL PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8579
Practice Address - Country:US
Practice Address - Phone:704-658-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner