Provider Demographics
NPI:1821527763
Name:STRAIT, CORNELIUS ISRAEL (CRNP)
Entity Type:Individual
Prefix:MR
First Name:CORNELIUS
Middle Name:ISRAEL
Last Name:STRAIT
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14993 GLADE TER
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-8496
Mailing Address - Country:US
Mailing Address - Phone:301-991-5138
Mailing Address - Fax:
Practice Address - Street 1:214 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:MC CONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233-8559
Practice Address - Country:US
Practice Address - Phone:717-485-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017511363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily