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Individual

LAURA JEAN CORNISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP, NP-C

Contact information

Practice address
1414 S 324TH ST STE B207, FEDERAL WAY, WA 98003-8444
(253) 220-3121
(415) 252-7176
Mailing address
1118 28TH AVENUE CT SW, PUYALLUP, WA 98373-1655
(253) 370-9671

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00149975
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
AP61111004
WA
363LA2200X
Adult Health Nurse Practitioner
APN0999305NP
CO

Other

Enumeration date
01/25/2016
Last updated
04/17/2025
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