Provider Demographics
NPI:1487662425
Name:CORNISH, CATHERINE DEBOO (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DEBOO
Last Name:CORNISH
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 PINELAND DR # 240
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5300
Mailing Address - Country:US
Mailing Address - Phone:469-637-2777
Mailing Address - Fax:469-637-2760
Practice Address - Street 1:5750 PINELAND DR # 240
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5300
Practice Address - Country:US
Practice Address - Phone:469-637-2777
Practice Address - Fax:469-637-2760
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP114185363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health