MRS. SHELLIA ANNE KORNEGAY (NPI# 1124258553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124258553 |
| Entity Type | Individual |
| Full Name | MRS. SHELLIA ANNE KORNEGAY |
| Credential | APN |
| Practice Address |
1515 West 42nd Street Pine Bluff AR 71602 |
| Mailing Address |
1515 W 42nd Ave Pine Bluff AR 71603-7004 |
| Practice Telephone | 8705417111 |
| Mailing Telephone | 8705417111 |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2013-11-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AO3247 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 180128758 | 05 |
| Street Address |
1515 WEST 42ND STREET |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265050447 | Bridget Furlong | Occupational Therapist | 2226 Barncy Lane, White Hall, AR 71602 | 2020-07-14 |
| 1609399963 | Interventional Surgery Institute of White Hall LLC | Clinic/Center | 7211 Dollarway Road, White Hall, AR 71602 | 2017-07-19 |
| 1679935761 | Pain Treatment Centers of America, Pllc | Durable Medical Equipment & Medical Supplies | 7211 Dollarway Rd, White Hall, AR 71602 | 2016-03-28 |
| 1326450446 | Rafeek Hegazy | Anesthesiology | 202 Frankie Ln, White Hall, AR 71602 | 2014-05-22 |
| 1275873515 | Craig Paul Anderson | Preventive Medicine | 13-020 Kabrich Circle, Pine Bluff, AR 71602 | 2013-02-24 |
| 1275789109 | Sarah Allison Rushing | Speech-Language Pathologist | 1020 West Holland Avenue, White Hall, AR 71602 | 2008-08-12 |
| 1245438852 | White Hall School District | Local Education Agency (LEA) | 1020 West Holland, White Hall, AR 71602 | 2007-07-05 |
| 1972622652 | Dewey Charles Scarbrough | Physician Assistant | 109 Frankie Lane, White Hall, AR 71602 | 2007-03-27 |
| 1427126135 | Donna D Massey | Dentist | 7215 Sheridan Road, White Hall, AR 71602 | 2006-12-01 |
| 1811068059 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 7203 Sheridan Rd, Ste D, White Hall, AR 71602 | 2006-11-10 |
| Find all providers in zip 71602 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811536931 | Tonya Aryet Mcbride | Nurse Practitioner | 509 Park Pl, Pine Bluff, AR 71601-6720 | 2020-01-06 |
| 1609340058 | Alicia Michelle Green-farris | Nurse Practitioner | 5510 S Olive St, Pine Bluff, AR 71603-7607 | 2019-01-18 |
| 1225503642 | Trisha E Blair | Nurse Practitioner | 3103 S Taft St, Pine Bluff, AR 71603-4427 | 2018-10-11 |
| 1144735424 | April Nicole Harris | Nurse Practitioner | 7500 Correction Cir, Pine Bluff, AR 71603-1496 | 2017-12-07 |
| 1790142974 | Ariel Lanice Jakes | Nurse Practitioner | 1609 W 40th Ave Ste 312, Pine Bluff, AR 71603-6366 | 2016-01-19 |
| 1134507650 | Estella Bland | Nurse Practitioner | 3803 Ridgway Rd, Pine Bluff, AR 71603-7452 | 2015-05-16 |
| 1033517768 | Lacy Rebaka Thomas | Nurse Practitioner | 6806 Mammoth Cv, Pine Bluff, AR 71603-4304 | 2014-12-11 |
| 1104245745 | Shanda Vinson | Nurse Practitioner | 1515 W 42nd Ave, Pine Bluff, AR 71603-7004 | 2014-04-10 |
| 1033405600 | Diana Gray Millenbaugh | Nurse Practitioner | 3801 Camden Rd Ste 12, Pine Bluff, AR 71603-4612 | 2011-06-22 |
| 1134370026 | Dorothy Jean Langel | Nurse Practitioner | 1600 W 42nd Ave, Pine Bluff, AR 71603-7006 | 2008-10-09 |
| Find all providers in PINE BLUFF | ||||
| City | PINE BLUFF |
| Zip Code | 71602 |
Please comment or provide details below to improve the information on MRS. SHELLIA ANNE KORNEGAY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.