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Individual

KATHRYN DAVENPORT CORNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A.P.R.N.

Contact information

Practice address
122 W MYRTLE ST, INDEPENDENCE, KS 67301-3317
(620) 577-4062
(620) 577-4064
Mailing address
800 W LAUREL ST, INDEPENDENCE, KS 67301-3211
(620) 332-3280
(620) 332-3281

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-102368-072
KS
363LF0000X
Family Nurse Practitioner
Primary
53-76887-072
KS

Other

Enumeration date
08/18/2015
Last updated
11/20/2018
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