| NPI | 1194390724 |
|---|---|
| Former Name | JESSICA E CORNWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.0027003) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2022-03-09 |