Individual
STACEY ANN CORNEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 695-6003
Mailing address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0105699
OK
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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