Individual
ALYSSA LEE ANN CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
135 WADE OWENS RD N, STANFORD, KY 40484
(606) 669-6006
(606) 661-0141
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4027
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3019103
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100894100
—
KY
Enumeration date
04/10/2023
Last updated
09/15/2025
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