Healthcare Provider Details

I. General information

NPI: 1326633850
Provider Name (Legal Business Name): ALAINA KRISTINE CORNELIUS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 5TH ST NE STE 10
BARBERTON OH
44203-3017
US

IV. Provider business mailing address

201 5TH ST NE STE 10
BARBERTON OH
44203-3017
US

V. Phone/Fax

Practice location:
  • Phone: 330-753-1001
  • Fax:
Mailing address:
  • Phone: 330-753-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number50.007069RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: