Provider Demographics
NPI:1245811611
Name:CORBIN, JUDITH CAROL (RN)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:CAROL
Last Name:CORBIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3697 LAGOON VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREENBANK
Mailing Address - State:WA
Mailing Address - Zip Code:98253-9749
Mailing Address - Country:US
Mailing Address - Phone:425-343-8964
Mailing Address - Fax:
Practice Address - Street 1:3697 LAGOON VIEW DR
Practice Address - Street 2:
Practice Address - City:GREENBANK
Practice Address - State:WA
Practice Address - Zip Code:98253-9749
Practice Address - Country:US
Practice Address - Phone:425-343-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-17
Last Update Date:2021-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60468148163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse