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General NPI Number Information
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NPI Number | 1053899682
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Entity Type | Individual
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Provider Name | HUGH COLBY CORNELSON FNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 655 JESSE JEWELL PKWY SE
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City | GAINESVILLE
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State | GA
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Zip | 30501-3756
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Country | US
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Telephone | 770-532-7092
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Fax | 770-536-0383
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Provider Business Mailing Address
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Address Line | PO BOX 658
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City | GAINESVILLE
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State | GA
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Zip | 30503-0658
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Country | US
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Telephone | 770-718-1122
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Fax | 770-533-4786
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP230883
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN230883
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License Number State | GA
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