Stacey Ann Corneil, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R0105699 Issued in OK

Practice address

781 Grand Casino Blvd
Shawnee, OK 74804-1005

Phone

(405) 695-6003

NPI assigned

Feb 13, 2025

Sex

Female

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1739404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1114732344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 GRAND CASINO BLVD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 GRAND CASINO BLVD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748041005",
            "telephone_number": "405-695-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEIL",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0105699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Wayne Copeland
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• Glen Courtney

• Registered Nurse in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.