Kelli Kilgro Cornelius, PHARMD
Individual provider Active NPI Pharmacist · Southside, AL
NPI 1033434121 · NPPES record last updated Mar 31, 2010
Key facts
- NPI
- 1033434121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 14386 (AL)
- Practice address
- 1514 Highway 77
Lawley Drug and Medical
Southside, AL 35907-0408 - Phone
- (256) 413-4473
- NPI assigned
- Mar 31, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14386 | AL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14386 | AL | Yes |
Addresses
Primary practice location
1514 Highway 77
Lawley Drug and Medical
Southside, AL 35907-0408
Mailing address
1514 Highway 77
Lawley Drug and Medical
Southside, AL 35907-0408
Phone (256) 413-4473
Other providers in Southside, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.