Provider Demographics
NPI:1477583631
Name:CORNELL, MICHELLE JOI (NP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:JOI
Last Name:CORNELL
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 1:51 PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2937
Mailing Address - Country:US
Mailing Address - Phone:407-936-2785
Mailing Address - Fax:407-936-2792
Practice Address - Street 1:51 PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2937
Practice Address - Country:US
Practice Address - Phone:407-936-2785
Practice Address - Fax:407-936-2792
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9258132363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care