Minnie Ellen Cornett, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041335897 Issued in IL

Practice address

1103 Belt Line Rd
Collinsville, IL 62234-4368

Phone

(618) 344-2273

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1063295194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 CHOUTEAU AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620402712",
            "telephone_number": "618-979-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 BELT LINE RD",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344368",
            "telephone_number": "618-344-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNETT",
        "first_name": "MINNIE",
        "middle_name": "ELLEN",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041335897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collinsville Pediatric Dentistry PLLC (Gateway Little Smiles)
• Collinsville Physical Therapy & Wellness, LLC
• Collinsville Unit School District #10
• Complete Spine and Performance LLC
• Courtney Gene Cooper, PT, DPT
• Joseph Michael Corvallis, M.D.
• Tonia Lynette Cotton
• Courtney Pharmacies, PC
• Audrey Crader
• Leah E Crask-Ellis, LPC, LCPC

• Registered Nurse in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.