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JEFFREY S CORNELIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
421 WEST COLLEGE ST, INFANTS AND CHILDRENS CLINIC PC, FLORENCE, AL 35630
(256) 764-9522
(256) 764-1139
Mailing address
421 WEST COLLEGE ST, INFANTS AND CHILDRENS CLINIC PC, FLORENCE, AL 35630
(256) 764-9522
(256) 764-1139

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1078351
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51093255
BC
AL
05
891002770
AL
Enumeration date
08/04/2006
Last updated
01/13/2011
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