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Individual

MRS. REBECCA JOLEEN CORNETT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6535
(913) 684-6536
Mailing address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6535
(913) 684-6536

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
14-65147-071
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14-65147-071
REGISTERED NURSE
KS
Enumeration date
10/26/2005
Last updated
07/08/2007
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