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Individual

JESSICA DEANN CORNELISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
27 CARTER 370, ELLSINORE, MO 63937-8191
(573) 944-7078
Mailing address
27 CARTER 370, ELLSINORE, MO 63937-8191
(573) 944-7078
(850) 732-8016

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019019286
MO
207QA0000X
Adolescent Medicine (Family Medicine) Physician
2019019286
MO
207QA0505X
Adult Medicine Physician
2019019286
MO
207V00000X
Obstetrics & Gynecology Physician
2019019286
MO
208000000X
Pediatrics Physician
2019019286
MO

Other

Enumeration date
12/11/2024
Last updated
07/28/2025
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