Individual
KRISTIN CORNELL
Active
Individual
KRISTIN CORNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
RT007346
PA
363AS0400X
Surgical Physician Assistant
Primary
C0009422
MD
363AS0400X
Surgical Physician Assistant
C5-0012078
DE
Other
Enumeration date
03/06/2024
Last updated
08/28/2024
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