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General NPI Number Information
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NPI Number | 1538813324
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Entity Type | Individual
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Provider Name | SANDRA M CORNINE APRN
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Gender | Female
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Dates
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Enumeration Date | 02/09/2022
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1713 US HIGHWAY 441 N STE D
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City | OKEECHOBEE
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State | FL
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Zip | 34972-1900
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Country | US
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Telephone | 863-225-1343
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Fax | 863-343-3812
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Provider Business Mailing Address
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Address Line | 3541 US HIGHWAY 441 S # 305
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City | OKEECHOBEE
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State | FL
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Zip | 34974-6247
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Country | US
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Telephone | 863-225-1343
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Fax | 863-343-3812
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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 | APRN11017677
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License Number State | FL
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