| NPI | 1659374130 |
|---|---|
| Former Name | ERICCA S CORNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MT 104569) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 45442) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 751749) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2007020392) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2022-07-21 |