Provider Demographics
NPI:1750274650
Name:CORNEJO, REINA I
Entity type:Individual
Prefix:
First Name:REINA
Middle Name:I
Last Name:CORNEJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2434
Mailing Address - Country:US
Mailing Address - Phone:814-547-3293
Mailing Address - Fax:
Practice Address - Street 1:119 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2434
Practice Address - Country:US
Practice Address - Phone:814-547-3293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula