Individual
DIANE LYNN CORNELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
121 CAHILL RD STE 204, BRANSON, MO 65616-1911
(417) 335-7222
(417) 335-7224
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
100882
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248623407
—
MO
Enumeration date
06/16/2006
Last updated
09/12/2022
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