Provider Demographics
NPI:1003236712
Name:CORNETT, BRIANNA D (NP)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:D
Last Name:CORNETT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 320
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:KY
Mailing Address - Zip Code:40823-0320
Mailing Address - Country:US
Mailing Address - Phone:606-233-1132
Mailing Address - Fax:
Practice Address - Street 1:900 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:KY
Practice Address - Zip Code:40823-1714
Practice Address - Country:US
Practice Address - Phone:606-233-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008624363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner