Individual
SAMANTHA A. CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4199 GATEWAY BLVD, NEWBURGH, IN 47630-8940
(812) 842-4200
Mailing address
PO BOX 637273, CINCINNATI, OH 45263-7273
(812) 842-4260
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002828A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002828A
STATE LICENSE
IN
05
—
300032484
—
IN
Enumeration date
10/18/2019
Last updated
12/09/2024
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