Individual
JANETTA CORNELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8921 S MINGO RD, TULSA, OK 74133-5841
(918) 252-8000
Mailing address
4605 S 289TH WEST AVE, MANNFORD, OK 74044-3088
(918) 504-5549
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
R0084962
OK
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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