Provider Demographics
NPI:1700478310
Name:CORNETT, CADI SUE (RN)
Entity Type:Individual
Prefix:
First Name:CADI
Middle Name:SUE
Last Name:CORNETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CADI
Other - Middle Name:SUE
Other - Last Name:THORNBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:424 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:OSAWATOMIE
Mailing Address - State:KS
Mailing Address - Zip Code:66064-1337
Mailing Address - Country:US
Mailing Address - Phone:913-755-5249
Mailing Address - Fax:
Practice Address - Street 1:424 PARKER AVE
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-1337
Practice Address - Country:US
Practice Address - Phone:913-755-5249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS143525163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse