Individual
RANDY DEAN CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
709 W MAIN ST, MANCHESTER, IA 52057-1526
(563) 927-7356
Mailing address
709 W MAIN ST, MANCHESTER, IA 52057-1526
(563) 927-7356
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D107246
IA
390200000X
Student in an Organized Health Care Education/Training Program
107246
IA
Other
Enumeration date
07/16/2008
Last updated
10/03/2013
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