Individual
BRIAN GREGORY CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5584
Mailing address
9096 COTTAGE RIDGE DR, SHREVEPORT, LA 71106
(281) 773-7169
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APO7222
LA
Other
Enumeration date
02/14/2013
Last updated
02/18/2013
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