Individual
JANE K CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2402 W PIERCE ST, SUITE 4-A, CARLSBAD, NM 88220-3537
(505) 234-9964
(505) 234-9962
Mailing address
2402 W PIERCE ST STE 6G, CARLSBAD, NM 88220-3566
(575) 628-0331
(575) 628-0332
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R49802
NM
363LP2300X
Primary Care Nurse Practitioner
Primary
CNP01235
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43580874
—
NM
Enumeration date
10/31/2005
Last updated
03/30/2018
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