Individual
MR. KEVIN MATTHEW CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-8707
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95086714
CA
363L00000X
Nurse Practitioner
Primary
RN10021104
MA
363LA2100X
Acute Care Nurse Practitioner
95018707
CA
Other
Enumeration date
09/01/2021
Last updated
04/30/2025
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