MEDICARE: RHONDA LYNN CORNELL DNP, APRN, CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R 108252-2	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760775654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA LYNN CORNELL DNP, APRN, CNP

Provider Business Mailing Address
First Line	:	2925 CHICAGO AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1321
Country	:	US
Telephone Number	:	612-262-9000
Fax Number	:	612-262-4259

Provider Business Practice Location Address
First Line	:	16150 PILOT KNOB RD
Second Line	:
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-4105
Country	:	US
Telephone Number	:	952-428-4225
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2011
Last Update Date	:	03/03/2020

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