Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD15036 | RI |
NPI | 1952586018 |
---|---|
Provider Name | Nicole Korbly |
First Address | Providence, RI 02903-4829 |
Second Address | Providence, RI 02903-4829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 05/12/2017 |