Individual
KATHERINE E CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 ST PAUL DR STE 201, CHAMBERSBURG, PA 17201
(717) 217-6944
(717) 217-6955
Mailing address
785 5TH AVE STE 3, CHAMBERSBURG, PA 17201-4232
(717) 263-9555
(717) 709-6529
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0110002292
VA
363AM0700X
Medical Physician Assistant
Primary
MA-053677
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007307260040
MEDICAID GROUP #
—
05
—
103165061 0001
—
PA
Enumeration date
05/25/2006
Last updated
09/08/2021
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