Kornegay, Shellia Anne
Kornegay, Shellia Anne is an sole proprietor health care provider with primary practice located at 1515 West 42Nd Street , Pine Bluff AR 71602. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kornegay, Shellia Anne can be contacted via phone (870) 541-7111.Contact Information
Primary practice address
1515 West 42Nd Street
Pine Bluff AR 71602
Phone: (870) 541-7111
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AO3247 | Arkansas |
Profile Details
| NPI number | 1124258553 |
|---|---|
| LBN Legal business name | Kornegay, Shellia Anne |
| Credentials | Advanced Practice Nurse (APN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 20th, 2009 |
| Last updated | Nov 15th, 2013 - about 11 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 | 1124258553 | NPPES |
| Arkansas | MEDICAID | 180128758 |
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