Penny S Cornelius, PA
Physician Assistant in Green Bay, WI. Individual provider (NPI-1).
NPI number1184609331
StatusActive
Last updated in NPPESNov 11, 2008
Details
- NPI
- 1184609331
- Entity type
- Individual (NPI-1)
- Name
- Penny S Cornelius
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2005
- Last updated
- Nov 11, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 696-023 | WI | Yes |
Practice location
2618 Forestville DrGreen Bay, WI 54304-1358
Phone 920-496-1631
Mailing address
2618 Forestville DrGreen Bay, WI 54304-1358
Phone 920-496-1631
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