Individual
MRS. WENDY W. CORNELIUS
Active
Individual
MRS. WENDY W. CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-325
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932896
—
AL
05
—
009955735
—
AL
01
—
051512489
BLUE CROSS - 48 MED PARK
AL
01
—
051514195
BLUE CROSS - 2660 10TH AV
AL
01
—
051514938
BLUE CROSS - 860 MONT RD
AL
05
—
891004890
—
AL
Enumeration date
05/27/2006
Last updated
05/27/2011
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