Provider Demographics
NPI:1053419812
Name:CORNELIUS, AUBRIE NORRIS (NP)
Entity type:Individual
Prefix:
First Name:AUBRIE
Middle Name:NORRIS
Last Name:CORNELIUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 WOODSON ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3255
Mailing Address - Country:US
Mailing Address - Phone:704-636-5576
Mailing Address - Fax:704-636-1755
Practice Address - Street 1:129 WOODSON ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3255
Practice Address - Country:US
Practice Address - Phone:704-636-5576
Practice Address - Fax:704-636-1755
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics