Provider Demographics
NPI:1801510607
Name:CORNETT, TERRI (APRN FNP-BC)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:CORNETT
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 SULPHUR RUN RD # ADDRESS2
Mailing Address - Street 2:
Mailing Address - City:ELK HORN
Mailing Address - State:KY
Mailing Address - Zip Code:42733-6723
Mailing Address - Country:US
Mailing Address - Phone:502-552-6058
Mailing Address - Fax:
Practice Address - Street 1:1173 SULPHUR RUN RD # ADDRESS2
Practice Address - Street 2:
Practice Address - City:ELK HORN
Practice Address - State:KY
Practice Address - Zip Code:42733-6723
Practice Address - Country:US
Practice Address - Phone:502-552-6058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1121784OtherAPRN LICENSE