Provider Demographics
NPI:1932989662
Name:CORNERSTONE FAMILY HEALTHCARE PLLC
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY HEALTHCARE PLLC
Other - Org Name:CORNERSTONE FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:KERSKER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP, FNP-C
Authorized Official - Phone:918-530-9859
Mailing Address - Street 1:265 E 460
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-2150
Mailing Address - Country:US
Mailing Address - Phone:918-530-9859
Mailing Address - Fax:
Practice Address - Street 1:24 QUAIL DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-2150
Practice Address - Country:US
Practice Address - Phone:918-302-1905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1003439258OtherINDIVIDUAL NPI