Provider Demographics
NPI:1871381988
Name:KORNEGAY, ANIKA SHARON (FNP-C)
Entity type:Individual
Prefix:
First Name:ANIKA
Middle Name:SHARON
Last Name:KORNEGAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3259 WATERCRESS DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1211
Mailing Address - Country:US
Mailing Address - Phone:561-492-3641
Mailing Address - Fax:
Practice Address - Street 1:3259 WATERCRESS DR
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1211
Practice Address - Country:US
Practice Address - Phone:561-492-3641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039126363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty