| Nicole Cornelius, | |
|
1600 Medical Pkwy, Carson City, NV 89703-4625 | |
| (775) 445-8000 | |
| Not Available |
| Full Name | Nicole Cornelius |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1600 Medical Pkwy, Carson City, Nevada |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417654799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | R243324 (Maryland) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | APRN.CRNA.0021076 (Ohio) | Primary |
| Entity Name | Lifebridge Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003992868 PECOS PAC ID: 2062514888 Enrollment ID: O20230627000605 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Cornelius, 12 S Potomac St, Baltimore, MD 21224-2249 Ph: () - | Nicole Cornelius, 1600 Medical Pkwy, Carson City, NV 89703-4625 Ph: (775) 445-8000 |
Mrs. Natalie Marie Coughlin, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1600 Medical Pkwy, Carson City, NV 89703 Phone: 775-445-8000 | |
Robert Giomi, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1600 Medical Pkwy, Carson City, NV 89703 Phone: 775-445-8000 | |
Mr. Stephen D Panter, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 313 West Ann Street, Carson City, NV 89703 Phone: 775-883-2202 Fax: 775-883-0797 | |
Mrs. Jennifer Buffum Brown, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1600 Medical Pkwy, Carson City, NV 89703 Phone: 775-450-5031 | |
Lindsay Carr, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1600 Medical Pkwy, Carson City, NV 89703 Phone: 775-445-8000 | |
Lindsey Pamela Tyndall, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1600 Medical Pkwy, Carson City, NV 89703 Phone: 775-445-8000 |