Individual
MS. CAROL S. CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
900 LINCOLN AVE, GRANT, NE 69140-3095
(308) 352-7200
(308) 352-7290
Mailing address
912 CENTRAL AVE, GRANT, NE 69140-3099
(308) 352-7100
(308) 352-7290
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
931
NE
Other
Enumeration date
12/04/2006
Last updated
10/02/2019
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