Provider Demographics
NPI:1811271398
Name:CORNELL, PATRICIA A (ANP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:CORNELL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 DANBY RD
Mailing Address - Street 2:HAMMOND HEALTH CENTER AT ITHACA COLLEGE
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-7000
Mailing Address - Country:US
Mailing Address - Phone:607-274-3177
Mailing Address - Fax:607-274-1844
Practice Address - Street 1:117 PARK LN
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-6309
Practice Address - Country:US
Practice Address - Phone:607-273-3054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300622-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily