Individual
RACHAEL D CORNUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1654 N DANEBO AVE, EUGENE, OR 97402-6416
(541) 515-5060
Mailing address
1654 N DANEBO AVE, EUGENE, OR 97402-6416
(541) 515-5060
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201701354LPN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201701354LPN
OREGON STATE BOARD OF NURSING
OR
Enumeration date
04/07/2021
Last updated
04/07/2021
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