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Individual

DR. NICOLE CORNISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, APRN-C

Contact information

Practice address
3400 S DOUGLAS BLVD, SUITE 305, OKLAHOMA CITY, OK 73150-1001
(405) 622-3063
(405) 732-0022
Mailing address
3400 S DOUGLAS BLVD, SUITE 305, OKLAHOMA CITY, OK 73150-1001
(405) 622-3063
(405) 732-0022

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
89710
OK
363LG0600X
Gerontology Nurse Practitioner
89710
OK
363LP2300X
Primary Care Nurse Practitioner
Primary
89710
OK

Other

Enumeration date
06/01/2015
Last updated
09/19/2016
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