Kelly Lynn Cornelison, PA-C, R.T. (R)
Physician Assistant in Durham, NC. Individual provider (NPI-1).
NPI number1043817620
StatusActive
Last updated in NPPESSep 27, 2024
Details
- NPI
- 1043817620
- Entity type
- Individual (NPI-1)
- Name
- Miss Kelly Lynn Cornelison
- Credential
- PA-C, R.T. (R)
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 6, 2020
- Certification date
- Sep 27, 2024
- Last updated
- Sep 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-14464 | NC | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | MA | |
| 363A00000X | Physician Assistant | PA8440 | MA |
Practice location
20 Duke Medicine Cir # 2-2Durham, NC 27710-2000
Phone 919-668-6688
Mailing address
20 Duke Medicine Cir # 2-2Durham, NC 27710-2000
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