Cornwall, Kelli Jean
Cornwall, Kelli Jean is an individual health care provider with primary practice located at 6140 Curtisian Ave Ste 102 , Boise ID 83704-0109. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Surgical Technologist, which is considered as her primary health care specialty. Cornwall, Kelli Jean can be contacted via phone (208) 367-2834.Contact Information
Primary practice address
6140 Curtisian Ave Ste 102
Boise ID 83704-0109
Phone: (208) 367-2834
Fax: (208) 367-4227
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Technologists, Technicians & Other Technical Service Providers / Surgical Technologist | 246ZS0410X | 86169 | Idaho |
Profile Details
| NPI number | 1578691036 |
|---|---|
| LBN Legal business name | Cornwall, Kelli Jean |
| Credentials | CFA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 28th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578691036 | NPPES |
| Idaho | Other | SA024 | BLUE CROSS |
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