Individual
KATIE ANN CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3518 PINE LN, LAFAYETTE, IN 47905-4077
(765) 337-4846
Mailing address
3518 PINE LN, LAFAYETTE, IN 47905-4077
(765) 337-4846
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28173431A
IN
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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