Individual
DIANNA L KORNHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1400 HIGHWAY 61, FESTUS, MO 63028-4100
(636) 933-1299
(636) 933-1224
Mailing address
PO BOX 350, CRYSTAL CITY, MO 63019-0350
(636) 933-1299
(636) 933-1224
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
118485
MO
363L00000X
Nurse Practitioner
118485
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
118485
MO
Other
Enumeration date
07/24/2009
Last updated
09/22/2010
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