Most Relevant Information
Provider Data
| NPI Number: | 1003296492 |
| Provider Name: | NICOLE CORNISH DNP, APRN-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | 89710 |
Most Important Dates
| Enumeration Date: | 06/01/2015 |
| Last Updated: | 09/19/2016 |
Provider Practice Location
3400 S DOUGLAS BLVD
SUITE 305
OKLAHOMA CITY
OK
731501001
Practice Location Phone/Fax
| Phone: | 4056223063 |
| Fax: | 4057320022 |
Provider Mailing Location
3400 S DOUGLAS BLVD
SUITE 305
OKLAHOMA CITY
OK
731501001
Provider Mailing Phone/Fax
| Phone: | 4056223063 |
| Fax: | 4057320022 |