Provider Demographics
NPI:1144277815
Name:CORBETT, JAMES ALAN (RN, FNP)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALAN
Last Name:CORBETT
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Gender:M
Credentials:RN, FNP
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Mailing Address - Street 1:1000 W NIFONG BLVD, BLDG. 1
Mailing Address - Street 2:STE 501
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-5615
Mailing Address - Country:US
Mailing Address - Phone:573-234-1800
Mailing Address - Fax:573-234-1799
Practice Address - Street 1:2511 W EDGEWOOD DR
Practice Address - Street 2:STE D
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5869
Practice Address - Country:US
Practice Address - Phone:573-761-2121
Practice Address - Fax:573-635-0726
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2016-06-13
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Provider Licenses
StateLicense IDTaxonomies
MO142061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO429284417Medicaid
MO824614627Medicare ID - Type Unspecified