Individual
DR. CAROLYN LAURICE JEFFERSON CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3131 LA CANADA ST, SUITE 241, LAS VEGAS, NV 89169-2578
(702) 693-6870
(702) 693-6899
Mailing address
2764 N GREEN VALLEY PKWY, SUITE 504, HENDERSON, NV 89014-2120
(702) 528-1668
(702) 982-5672
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
12973
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275772006
—
NV
Enumeration date
02/18/2009
Last updated
07/14/2010
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